COURTNEY BULLARD (NPI# 1134772304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134772304 |
Entity Type | Individual |
Full Name | COURTNEY BULLARD |
Credential | AGNP-C |
Practice Address |
1966 F S Hill Dr Grenada MS 38901-5047 |
Practice Telephone | 6626881519 |
Mailing Telephone | 6626881519 |
Enumeration Date | 2019-07-17 |
Last Update Date | 2020-05-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
903421 | MS | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
903421 | MS | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1966 F S HILL DR |
City | GRENADA |
State | MS |
Zip Code | 38901-5047 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548765548 | Amy Wilson Mccarley | Physical Therapist | 1966 F S Hill Dr, Grenada, MS 38901-5047 | 2018-03-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902435118 | The Mane Physician | Prosthetic/Orthotic Supplier | 94 Spain Drive, Grenada, MS 38901 | 2020-04-08 |
1942842166 | Sylvia C Bass | Technician | 813 Union Street, Grenada, MS 38901 | 2019-10-09 |
1669971180 | Jenny Taylor | Nurse Practitioner | 350 Sunset Drive, Grenada, MS 38901 | 2018-02-10 |
1073912762 | John Thomas Mcree I | Counselor | 2026 Commerce St Ste 8e, Grenada, MS 38901 | 2014-08-19 |
1700213634 | State of Mississippi-university of Mississippi Medical Center | Home Health | 960 Avent Drive, Grenada, MS 38901 | 2013-10-10 |
1114359866 | Cmhp Enterprises | Dentist | 1420 Wooded Drive, Grenada, MS 38901 | 2013-08-05 |
1518256460 | Mercy Hospice LLC | Hospice Care, Community Based | 1410 Wooded Drive, Grenada, MS 38901 | 2011-03-31 |
1215256318 | Della Lea Welsh | Speech-Language Pathologist | 1321 Dd Sunset Dr., Grenada, MS 38901 | 2010-05-28 |
1750514543 | Family Health Care Clinic, Inc. | Clinic/Center | 1102 Telegraph St, Grenada, MS 38901 | 2009-08-27 |
1033384771 | Jason K Bennett | Pharmacist | 140 Shadow Wood Cv, Grenada, MS 38901 | 2008-04-24 |
Find all providers in zip 38901 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
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1902421746 | Rebecca Mcwhirter | Nurse Practitioner | 1512 Roswell Dr, Jackson, MS 39211-5928 | 2020-06-08 |
1548896301 | Rochelle Vanity Cork | Nurse Practitioner | 4635 Us-80, Pearl, MS 39208 | 2020-03-12 |
1285287698 | Veronica Lynn Walker | Nurse Practitioner | 180-b Debuys Road, Biloxi, MS 39531 | 2019-07-24 |
1104387695 | Chatina Spears Martin | Nurse Practitioner | 308 Melba Hill Dr, Jackson, MS 39209-2833 | 2019-03-27 |
1366915886 | Rockell Ann Pearl Singleton | Nurse Practitioner | 6490 U S Highway 49 Apt 277, Hattiesburg, MS 39401-3013 | 2019-01-08 |
1326513920 | Jacquelyn Bruner Ray | Nurse Practitioner | 6102 11th Ave, Meridian, MS 39305-1219 | 2018-10-10 |
1487162319 | Mary Melvin Smith | Nurse Practitioner | 107 Cannon Run, Canton, MS 39046-8033 | 2018-01-12 |
1669987723 | Harmony House Calls LLC | Nurse Practitioner | 5140 Galaxie Dr Ste 105, Jackson, MS 39206 | 2017-12-11 |
1417467168 | Jason Michael Butler | Nurse Practitioner | 129 Center St Ste B, Richland, MS 39218-4800 | 2017-10-09 |
1780125302 | Debra Brown Willis | Nurse Practitioner | 216 Belle Oak Dr, Brandon, MS 39042-8251 | 2017-03-15 |
Find all providers with the same taxonomy |
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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.