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Individual
BLAKE DAVID BULGER
Active
Individual
BLAKE DAVID BULGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
206761
OK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
226137
AR
Other
Enumeration date
11/21/2022
Last updated
09/20/2023
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