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Individual

JENNIFER BULLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, FNP

Contact information

Practice address
993 SISKIYOU BLVD STE 1, ASHLAND, OR 97520-3943
(541) 631-8387
(541) 708-6090
Mailing address
993 SISKIYOU BLVD STE 1, ASHLAND, OR 97520-3943
(541) 631-8387
(541) 708-6090

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
201041940RN
OR
363LF0000X
Family Nurse Practitioner
Primary
201608796NP-PP
OR

Other

Enumeration date
07/20/2015
Last updated
05/20/2024
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