Individual
JUDITH E BULLUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
815 W ROCK PL, GLENDALE, WI 53209-6529
(414) 708-9664
Mailing address
815 W ROCK PL, GLENDALE, WI 53209-6529
(414) 708-9664
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
90965-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90965-030
RN
WI
Enumeration date
11/20/2008
Last updated
11/20/2008
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