Individual
NELLIE LAVERNE BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15427 GOSHEN RD, MONTPELIER, VA 23192-2304
(347) 465-1496
Mailing address
15427 GOSHEN RD, MONTPELIER, VA 23192-2304
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
0001262015
VA
Other
Enumeration date
05/30/2026
Last updated
05/30/2026
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