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Individual

MRS. MARY K. BULLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
305 TAYLOR ST # 402, BUTLER, KY 41006-1042
(731) 394-1145
Mailing address
PO BOX 269084, DEPT 1102, OKLAHOMA CITY, OK 73126

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3010516
KY
363LF0000X
Family Nurse Practitioner
3010516
KY

Other

Enumeration date
09/12/2016
Last updated
09/16/2025
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