Individual
EDWINA KUM BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4543 S 39TH ST, OMAHA, NE 68107-1246
(402) 301-9560
Mailing address
4543 S 39TH ST, OMAHA, NE 68107-1246
(402) 301-9560
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
07/26/2025
Last updated
07/26/2025
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