Organization
SHARON M BULLOCK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARON M BULLOCK LPN (INDEPENDENT LPN)
(513) 709-9344
Entity
Organization
Contact information
Practice address
4549 COOPER RD, BLUE ASH, OH 45242-5607
(513) 398-2456
Mailing address
4549 COOPER RD, BLUE ASH, OH 45242-5607
(513) 398-2456
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
PN090343
OH
251E00000X
Home Health Agency
PN090343
OH
302F00000X
Exclusive Provider Organization
PN090343
OH
302R00000X
Health Maintenance Organization
Primary
PN090343
OH
305R00000X
Preferred Provider Organization
PN090343
OH
343900000X
Non-emergency Medical Transport (VAN)
BRODI
OH
347C00000X
Private Vehicle
RP227337
OH
Other
Enumeration date
07/31/2006
Last updated
09/11/2025
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