Individual
DEBORAH BULLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
2605 E 141ST ST, EAST CHICAGO, IN 46312-2948
(219) 392-7710
Mailing address
2605 E 141ST ST, EAST CHICAGO, IN 46312-2948
(219) 392-7710
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
45-01-97-1404
IN
Other
Enumeration date
07/20/2007
Last updated
07/20/2007
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