Individual
STACY BULLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
500 W MAIN ST, MANDAN, ND 58554-3146
(701) 663-5373
Mailing address
500 W MAIN ST, MANDAN, ND 58554-3146
(701) 663-5373
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L13546
ND
Other
Enumeration date
01/19/2014
Last updated
01/19/2014
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