MRS. TRACEY BULLARD (NPI# 1033463880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033463880 |
| Entity Type | Individual |
| Full Name | MRS. TRACEY BULLARD |
| Credential | FNP |
| Practice Address |
13523 Herndon Oak Grove Rd Oak Grove KY 42262-9369 |
| Practice Telephone | 2708399697 |
| Mailing Telephone | 2708399697 |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2012-11-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SE0003X |
Clinical Nurse Specialist Specialization: Emergency |
3007747 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
13523 HERNDON OAK GROVE RD |
| City | OAK GROVE |
| State | KY |
| Zip Code | 42262-9369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023381969 | Jennifer Jean Johnson | Nurse Practitioner | 1654 Hugh Hunter Rd #20, Oak Grove, KY 42262 | 2012-02-22 |
| 1053602367 | Jabez Empowerment, LLC | In Home Supportive Care | 175 Stateline Road, Suite 4, Oak Grove, KY 42262 | 2011-04-21 |
| 1215171251 | Kimberly Cecil-riddle | Nurse Practitioner | 2801 Walter Garrett Lane, Oak Grove, KY 42262 | 2009-04-21 |
| 1598105488 | Randi Arlene Carr | Developmental Therapist | 304 Wilson Dr, Oak Grove, KY 42262-4210 | 2013-06-25 |
| 1780714956 | Maleka Monique Holmes | Social Worker | 180 Mandarin Dr, Oak Grove, KY 42262-7215 | 2007-03-06 |
| 1720454507 | Pennyroyal Healthcare Services, Inc. | Clinic/Center | 244 Thompsonville Ln, Oak Grove, KY 42262-8250 | 2015-08-17 |
| 1699129486 | Akeisha Danielle Peek | Developmental Therapist | 503 Gainey Dr, Oak Grove, KY 42262-8259 | 2016-04-18 |
| 1366859803 | Air Affiliates, Inc. | Durable Medical Equipment & Medical Supplies | 175 Stateline Rd Ste R-4, Oak Grove, KY 42262-8288 | 2014-07-16 |
| 1538482773 | Eddie A Manley | Nurse Practitioner | 175 Stateline Rd, Oak Grove, KY 42262-8288 | 2010-03-02 |
| 1902189541 | Priority Care Associates | Nurse Practitioner | 175 Stateline Rd, Oak Grove, KY 42262-8288 | 2011-09-20 |
| Find all providers in zip 42262 | ||||
| Taxonomy Code | 364SE0003X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Emergency |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.