Individual
MS. CHANEL DOMINQUE BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, FNP-C
Contact information
Practice address
2711 W KINGSHIGHWAY STE 10, PARAGOULD, AR 72450-2645
(877) 522-1275
(833) 888-7145
Mailing address
108 N SHACKLEFORD RD, LITTLE ROCK, AR 72211-2840
(844) 215-0731
(888) 630-8885
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A005316
AR
Other
Enumeration date
11/02/2017
Last updated
11/12/2024
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