Individual
CHARLES MONROE BULLINS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
201 CRYSTAL SPRING AVE SW, SUITE 201, ROANOKE, VA 24104
(540) 853-0100
Mailing address
625 DELAWARE ST, SALEM, VA 24153-5044
(540) 589-6217
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024171785
VA
Other
Enumeration date
04/29/2014
Last updated
06/23/2014
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