Individual
CHAD BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
8420 S EASTERN AVE STE 101, LAS VEGAS, NV 89123-2875
(702) 483-3554
(725) 267-1020
Mailing address
8379 W SUNSET RD STE 210, LAS VEGAS, NV 89113-2243
(725) 200-3232
(725) 220-6389
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN001894
NV
363LF0000X
Family Nurse Practitioner
001894
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447642517
—
NV
Enumeration date
02/26/2015
Last updated
01/13/2023
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