Individual
BIANCA BULLIE-THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C, PMHNP-BC
Contact information
Practice address
1500 E WOODROW WILSON, JACKSON, MS 39216
(601) 362-4471
(601) 368-4089
Mailing address
1500 E WOODROW WILSON, JACKSON, MS 39216
(601) 362-4471
(601) 368-4089
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
867841
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2022153286
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022153286
PMHNP - ANCC
—
01
—
F1111175
NATIONAL NURSE PRACTITIONER LICENSE
—
01
—
RN867841
MS BOARD OF NURSING LICENSE NUMBER
MS
Enumeration date
11/24/2011
Last updated
06/04/2025
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