Individual
LORRAINE BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 PARK HILL DR, FREDERICKSBURG, VA 22401-3387
(540) 361-7641
(540) 361-1246
Mailing address
PO BOX 1460, FREDERICKSBURG, VA 22402-1460
(540) 785-2100
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024168125
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316183023
VA PREMIER
VA
05
—
1316183023
—
VA
Enumeration date
12/30/2008
Last updated
10/03/2014
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