Individual
JANINE WRIGHT BULLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11 DOCTORS PARK DR STE 240, SPARTANBURG, SC 29307-1008
(864) 342-4115
(864) 342-4064
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
21986
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP5485
—
SC
01
—
SCE6015206
MEDICARE PIN
SC
Enumeration date
07/09/2018
Last updated
12/08/2020
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