MARY BULLIS


Address: 700 Broadway, Fort Wayne, IN 46802-1402
Phone: 2604253538

MARY BULLIS (NPI# 1265825178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265825178
Entity Type Individual
Full Name MARY BULLIS
Credential NP
Practice Address 700 Broadway
Fort Wayne
IN 46802-1402
Mailing Address 4203 River Bluff Dr
Fort Wayne
IN 46835-1436
Practice Telephone 2604253538
Mailing Telephone 2603124007
Enumeration Date 2015-03-17
Last Update Date 2015-03-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 71005389A IN Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 700 BROADWAY
City FORT WAYNE
State IN
Zip Code 46802-1402

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104825140 Select Specialty Hospital - Fort Wayne Inc Long Term Care Hospital 700 Broadway, 7th Fl East, Fort Wayne, IN 46802-1402 2005-07-20
1598395238 Werner R Wolff Nurse Practitioner 700 Broadway, Fort Wayne, IN 46802-1402 2020-01-22
1477114312 Mandy Onguta Nurse Practitioner 700 Broadway, Fort Wayne, IN 46802-1402 2019-06-21
1609386416 Kelly Marie Snyder Occupational Therapy Assistant 700 Broadway, Fort Wayne, IN 46802-1402 2017-10-06
1851759922 Faysal Massarweh Internal Medicine 700 Broadway, Fort Wayne, IN 46802-1402 2016-02-04
1689041451 Christine Montanaro Registered Nurse 700 Broadway, Fort Wayne, IN 46802-1402 2015-08-28
1366883068 Niroshan Kirupananthan Internal Medicine 700 Broadway, Fort Wayne, IN 46802-1402 2013-07-10
1548552375 Musa Abdalla Family Medicine 700 Broadway, Fort Wayne, IN 46802-1402 2011-05-12
1366754616 Darnell J Brown Surgery 700 Broadway, Fort Wayne, IN 46802-1402 2010-07-01
1962722991 Lutheran Health Network General Acute Care Hospital 700 Broadway, Fort Wayne, IN 46802-1402 2010-06-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1568084416 Renaissance Counseling Center,llc Community/Behavioral Health 1210 Guthrie St, Fort Wayne, IN 46802 2020-05-14
1699260182 Tina Huffman Counseling Services LLC Clinic/Center 2323 111 W. Berry St., Fort Wayne, IN 46802 2018-06-27
1669879664 Neighborhood Health Clinics, Inc Clinic/Center 1721 S Calhoun St, Fort Wayne, IN 46802 2014-11-20
1205272168 Tyler Jerome Kimmel Dentist 1717 S. Calhoun Street, Fort Wayne, IN 46802 2013-05-20
1174899405 Hearcare Connection, Inc. Audiologist 130 W Main St Ste 150, Fort Wayne, IN 46802 2012-03-30
1801114533 Hoosier Sports & Chiropractic LLC Chiropractor 122 W Wayne Street, Fort Wayne, IN 46802 2010-05-05
1891912523 Krista Lohmar Speech-Language Pathologist 3340 North Washington Road, Ft. Wayne, IL 46802 2007-04-20
1811047608 Catholic Charities of The Diocese of Fort Wayne-south Bend, Inc. Counselor 915 South Clinton, Fort Wayne, IN 46802 2007-01-12
1548323801 Clifford T Salk Dentist 122 W Washington Blvd, Fort Wayne, IN 46802 2006-12-18
1720155492 Kristina Wise Social Worker 203 W Wayne St Ste 317, Fort Wayne, IN 46802 2006-11-29
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1891394599 Laury Farrell Nurse Practitioner 6017 Stoney Creek Dr, Fort Wayne, IN 46825-4410 2020-10-22
1730787599 Crystal Neal Nurse Practitioner 4430 Keeneland Ln Unit 202, Fort Wayne, IN 46845-1985 2020-10-14
1225668312 Kathleen Vanderreyden Nurse Practitioner 3005 E State Blvd, Fort Wayne, IN 46805-4736 2020-01-17
1043703903 Kara Stackhouse Nurse Practitioner 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 2018-06-14
1275980690 April Anderson Nurse Practitioner 6920 Pointe Inverness Way Ste 120, Fort Wayne, IN 46804-7926 2016-05-16
1922470970 Jennifer Carol Littke Nurse Practitioner 6326 Constitution Dr, Fort Wayne, IN 46804-1518 2015-10-28
1275956054 Andrea N Lahrman Nurse Practitioner 11123 Parkview Plaza Dr Ste 106, Fort Wayne, IN 46845-1707 2014-01-29
1417213729 Laura Beth Baker Nurse Practitioner 5750 Falls Drive, Fort Wayne, IN 46804-7147 2012-04-11
1447572441 Kathryn L Smith Nurse Practitioner 11104 Parkview Circle Dr Ste 20, Fort Wayne, IN 46845-1733 2010-02-18
1316180144 Braden M Butterfield Mckinley Nurse Practitioner 2101 E Coliseum Blvd Rm 234, Fort Wayne, IN 46805-1445 2009-04-09
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Competitor

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City FORT WAYNE
Zip Code 46802

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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