Mary G Bullock is a Family in Roseville, Minnesota. Mary G Bullock practices all healthcare services and medical treatments related to Family. The NPI Number for Mary G Bullock is 1205932902. The last update date is 2012-04-25.
Mary G Bullock's current location address is 2845 Hamline Ave North, Roseville, Minnesota. You can contact this provider via phone number 6516316100 and fax number 6516316343. The mailing address for Mary G Bullock is 2845 Hamline Ave North, Roseville, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary G Bullock |
|---|---|
| Address | 2845 Hamline Ave North, Roseville, Minnesota |
| Phone Number | 6516316100 |
| Fax Number | 6516316343 |
| Sole Proprietor | Y |
| Credentials | RN, CNP |
NPI Number Detail
| NPI Number | 1205932902 |
|---|---|
| Provider Enumeration Date | 2006-09-16 |
| Last Updated Date | 2012-04-25 |
Provider Mailing Address Detail
| Address | 2845 Hamline Ave North |
|---|---|
| City | Roseville |
| State | Minnesota (MN) |
| Post Code | 55113 |
| Phone Number | 6516316100 |
| Fax Number | 6516316343 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | R119074-4 |
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Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 6676570-0 | MN | -- |
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What is the unique 10-digit identification code issued to Mary G Bullock by the Centers for Medicare & Medicaid Services?
The Mary G Bullock has been assigned the NPI (National Provider Identifier) 1205932902 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Where is the Mary G Bullock located?
The Mary G Bullock is located at 2845 Hamline Ave North, Roseville, MN 55113.
What is Mary G Bullock's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mary G Bullock's area of specialization is Family, and the corresponding taxonomy code that categorizes this field of practice is 363Lf0000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1205932902 to Mary G Bullock?
The Centers for Medicare & Medicaid Services originally issued the 1205932902 to Mary G Bullock on 2006-09-16.
When was the information regarding Mary G Bullock, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Mary G Bullock, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2012-04-25.