Individual
ANGELA KENNEDY BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1909 US HIGHWAY 82 W STE 5, TIFTON, GA 31793-8213
(229) 386-4300
(229) 386-8300
Mailing address
1909 US HIGHWAY 82 W STE 5, TIFTON, GA 31793-8213
(229) 386-4300
(229) 386-8300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN192489
GA
363LF0000X
Family Nurse Practitioner
Primary
RN192489
GA
Other
Enumeration date
03/08/2018
Last updated
12/19/2023
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