Individual
SHEILA DIANE BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
307 1ST AVE NW, KENMARE, ND 58746-7104
(701) 385-4283
Mailing address
3140 LOWRY RD, LEWISBURG, TN 37091-6334
(850) 449-4092
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2495886
MN
363L00000X
Nurse Practitioner
R48267
ND
363LF0000X
Family Nurse Practitioner
Primary
902510
MS
Other
Enumeration date
02/26/2018
Last updated
02/10/2026
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