Individual
AMANDA BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
611 TWO MILE AVE, WISCONSIN RAPIDS, WI 54494-6560
(715) 424-6793
(715) 424-6794
Mailing address
611 TWO MILE AVE, WISCONSIN RAPIDS, WI 54494-6560
(715) 424-6793
(715) 424-6794
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
258475-30
WI
Other
Enumeration date
05/13/2026
Last updated
05/13/2026
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