Individual
PATRICIA BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
403 PINE ST, TAYLORSVILLE, MS 39168-5659
(601) 452-7080
(601) 452-7083
Mailing address
403 PINE ST, TAYLORSVILLE, MS 39168-5659
(601) 452-7080
(601) 452-7083
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R852050
MS
Other
Enumeration date
03/28/2011
Last updated
12/02/2021
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