Individual
MRS. SANDRA JEAN BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
400 COLLINGWOOD BLVD, LIMA, OH 45801-1811
(419) 303-9408
Mailing address
400 COLLINGWOOD BLVD, LIMA, OH 45801-1811
(419) 303-9408
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
RN364784
OH
163WH0200X
Home Health Registered Nurse
Primary
RN364784
OH
163WH1000X
Hospice Registered Nurse
RN364784
OH
163WI0500X
Infusion Therapy Registered Nurse
RN364784
OH
Other
Enumeration date
12/17/2012
Last updated
12/17/2012
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