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Individual

REBECCA ANNE BULLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP-BC

Contact information

Practice address
757 WESTWOOD PLZ, LOS ANGELES, CA 90095-0001
(310) 301-6800
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95023980
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95023980
CALIFORNIA BOARD OF REGISTERED NURSING, NURSE PRACTITIONER LICENSE
CA
Enumeration date
01/31/2023
Last updated
06/15/2023
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