Jessica Bullock (NPI# 1609262278, PAC ID# 2163743527) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1609262278 |
| PAC ID by PECOS | 2163743527 |
| Professional Enrollment ID | I20170829000793 |
| Full Name | Jessica Bullock |
| Organization Legal Name | COMMUNITY CLINIC OF MAUI, INC. |
| Address |
1881 Nani St Wailuku HI 96793-1811 |
| Phone Number | 8088717772 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 2466365440 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1881 Nani St, Wailuku, HI 96793-1811 | 8088717772 | COMMUNITY CLINIC OF MAUI, INC. |
| Organization Legal Name | COMMUNITY CLINIC OF MAUI, INC. |
| Physicians | 16 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Travis Walling | Nurse Practitioner | Community Clinic of Maui, Inc. | 1881 Nani St, Wailuku, HI 96793-1811 |
| Zena I Monji | Obstetrics/gynecology | Community Clinic of Maui, Inc. | 670 -a Waiale Dr, Wailuku, HI 96793-2376 |
| Michael C Aaronoff | Obstetrics/gynecology | Community Clinic of Maui, Inc. | 15 Ipu Aumakua Ln, Lahaina, HI 96761-1193 |
| Aaron Altura | Obstetrics/gynecology | Community Clinic of Maui, Inc. | 15 Ipu Aumakua Ln, Lahaina, HI 96761-1193 |
| Ivy Lou Hibbitt | Nurse Practitioner | Community Clinic of Maui, Inc. | 15 Ipu Aumakua Ln, Lahaina, HI 96761-1193 |
| Jason M Laird | Internal Medicine | Community Clinic of Maui, Inc. | 15 Ipu Aumakua Ln, Lahaina, HI 96761-1193 |
| Gabrielle O Sullivan | Family Medicine | Community Clinic of Maui, Inc. | 1881 Nani St, Wailuku, HI 96793-1811 |
| Jaimie Mariko Johnson | Obstetrics/gynecology | Community Clinic of Maui, Inc. | 15 Ipu Aumakua Ln, Lahaina, HI 96761-1193 |
| Erik L Russell | Internal Medicine | Community Clinic of Maui, Inc. | 15 Ipu Aumakua Ln, Lahaina, HI 96761-1193 |
| Daniel Nead | Psychologist, Clinical | Community Clinic of Maui, Inc. | 15 Ipu Aumakua Ln, Lahaina, HI 96761-1193 |
| Street Address |
1881 NANI ST |
| City | WAILUKU |
| State | HI |
| Zip | 96793-1811 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Travis Walling | Nurse Practitioner | Community Clinic of Maui, Inc. | 1881 Nani St, Wailuku, HI 96793-1811 |
| Gabrielle O Sullivan | Family Medicine | Community Clinic of Maui, Inc. | 1881 Nani St, Wailuku, HI 96793-1811 |
| Sarah Feenstra | Psychiatry | Community Clinic of Maui, Inc. | 1881 Nani St, Wailuku, HI 96793-1811 |
| Douglas Nelsen | Family Practice | Community Clinic of Maui, Inc. | 1881 Nani St, Wailuku, HI 96793-1811 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Soren Carlsen | Urology | 1883 Mill St, Wailuku, HI 96793-1236 | |
| Robert D Lanser Jr. | Clinical Social Worker | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| David J Wittenberg | Psychologist, Clinical | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| Bahram Taghavi | Psychiatry | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| Margaret E Goldberg | Clinical Social Worker | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| George L Carlson | Addiction Medicine | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| Connie J Debord | Clinical Social Worker | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| Joel Tapler | Clinical Social Worker | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| Royal Randolph Jr. | Psychiatry | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| Sharilyn Jane Butteling | Nurse Practitioner | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| Find all physicians in zip 96793 | |||
| City | WAILUKU |
| Zip Code | 96793 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | WAILUKU + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.