Individual
HEATHER MARIE BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
619 SULLIVAN RD, STATESVILLE, NC 28677-3437
(704) 871-0934
(704) 402-1065
Mailing address
3612 26TH STREET DR NE, HICKORY, NC 28601-7206
(704) 490-8298
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
189139
NC
Other
Enumeration date
03/02/2022
Last updated
03/02/2022
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