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Individual

ASHLEY RENEA BULLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4581 LAKE AVE APT C, ROCHESTER, NY 14612-4528
(585) 784-0534
Mailing address
4581 LAKE AVE APT C, ROCHESTER, NY 14612-4528
(585) 784-0534

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
696238-1
NY
164W00000X
Licensed Practical Nurse
302545-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
309488
NY

Other

Enumeration date
11/03/2010
Last updated
07/26/2021
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