Individual
BRENDA R BULLERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
201 MAINE AVE, ADRIAN, MN 56110-1214
(507) 483-2668
(507) 483-2925
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9556
(605) 328-9501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9095
MN
363AS0400X
Surgical Physician Assistant
0590
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6823472
—
SD
Enumeration date
06/13/2005
Last updated
05/22/2020
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