Individual
SUZANNE BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
565 RADIO HILL RD, MARION, VA 24354-6587
(276) 782-1194
Mailing address
PO BOX 916, DAMASCUS, VA 24236-0916
(276) 475-3788
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0001122983
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962471748
—
VA
Enumeration date
03/15/2006
Last updated
03/28/2008
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