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Individual

MRS. SUSAN GIBBS BULLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N, PHN

Contact information

Practice address
14215 ROAD 28, MADERA, CA 93638-5729
(559) 662-8314
(559) 675-7983
Mailing address
14215 ROAD 28, MADERA, CA 93638-5729
(559) 675-4945
(559) 675-7983

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN492295
CA

Other

Enumeration date
01/25/2013
Last updated
01/29/2013
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