PATRICIA BULLOCK (NPI# 1679862817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679862817 |
| Entity Type | Individual |
| Full Name | PATRICIA BULLOCK |
| Credential | NP-C |
| Practice Address |
126 W Central Ave Petal MS 39465-2314 |
| Mailing Address |
1203 Jefferson St Laurel MS 39440-4354 |
| Practice Telephone | 6013364387 |
| Mailing Telephone | 6016492863 |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2015-11-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R852050 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386093078 | Patricia Tammette Bullock | Counselor | 622 Riverside Dr, Monroe, LA 71201-6211 | 2016-06-03 |
| 1609009877 | Patricia J. Bullock | Counselor | 1500 Petaluma Blvd S Ste A, Petaluma, CA 94952 | 2009-09-03 |
| 1073713889 | Patricia Bullock | Physical Therapist | 101 Uhland Rd Ste 112, San Marcos, TX 78666-6681 | 2007-07-19 |
| Street Address |
126 W CENTRAL AVE |
| City | PETAL |
| State | MS |
| Zip Code | 39465-2314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033475967 | Paki Inc | Clinic/Center | 126 W Central Ave, Petal, MS 39465-2314 | 2012-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164055489 | R&p Elite Services, LLC | Private Vehicle | 68 Springfield Rd., Petal, MS 39465 | 2020-02-14 |
| 1003460544 | Hayden White | Pharmacist | 36 Byrd Dr., Petal, MS 39465 | 2019-08-01 |
| 1134612971 | Chandler Mccarley Hawkins | Dentist | 1115 Evelyn Gandy Parkway, Petal, MS 39465 | 2018-06-06 |
| 1881199818 | Lauren O'neal Garner | Nurse Practitioner | 36 Stadium Drive, Petal, MS 39465 | 2018-03-30 |
| 1700036928 | Petal School District | Registered Nurse | 60 Herrington Road, Petal, MS 39465 | 2008-09-24 |
| 1962679043 | Hattiesburg Eye Clinic Pa | Optometrist | 1223 Hwy 42, Ste 140, Petal, MS 39465 | 2008-05-08 |
| 1023228640 | Noal Baxter Cochran | Marriage & Family Therapist | 80 Lakeland Circle, Petal, MS 39465 | 2007-05-23 |
| 1750596938 | James A Nicholson Dds Pa | Dentist | 120 South 28th Avenue, Hattiesburg, MS 39465 | 2007-05-11 |
| 1356563605 | Petal School District | Registered Nurse | 400 Hillcrest Loop, Petal, MS 39465 | 2007-05-03 |
| 1154480804 | Mary E Thomsen | Orthotic Fitter | 173 Cherry Oak Trail, Petal, MS 39465 | 2006-12-08 |
| Find all providers in zip 39465 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881199818 | Lauren O'neal Garner | Nurse Practitioner | 36 Stadium Drive, Petal, MS 39465 | 2018-03-30 |
| 1578190443 | Raven Miller | Nurse Practitioner | 201 S Main St, Petal, MS 39465-2362 | 2020-03-23 |
| 1396217345 | David Lee Snodgrass | Nurse Practitioner | 1146 Evelyn Gandy Pkwy, Petal, MS 39465-3947 | 2018-12-31 |
| 1285083238 | Marla Mathis, Fnp | Nurse Practitioner | 130 N Main St, Petal, MS 39465-2345 | 2016-06-10 |
| 1649689548 | Dayna Hamm Pridgen | Nurse Practitioner | 50 Parkway Ln Ste B, Petal, MS 39465-3035 | 2014-08-05 |
| 1114291184 | Hang My-thi Nguyen | Nurse Practitioner | 100 Eastbrook Dr Ste 30, Petal, MS 39465-6012 | 2012-03-08 |
| 1891941241 | Misty Walker Cagle | Nurse Practitioner | 50 Parkway Ln, Petal, MS 39465-3035 | 2008-08-15 |
| 1972662427 | Marla V Mathis | Nurse Practitioner | 130 N Main St, Petal, MS 39465-2345 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205423 | Ronequa Evans | Nurse Practitioner | 811 Clubhouse Dr, Pearl, MS 39208-7023 | 2020-11-02 |
| 1659971380 | Lucy M Barnes | Nurse Practitioner | 2401 State Blvd, Meridian, MS 39307-5033 | 2020-10-30 |
| 1952901076 | Angela Holloway | Nurse Practitioner | 1316 County Road 94, New Albany, MS 38652-8556 | 2020-10-28 |
| 1073113304 | Tasha Rucker | Nurse Practitioner | 2372 Us49-e, Sumner, MS 38957 | 2020-10-27 |
| 1881293371 | Hanna Fernandez | Nurse Practitioner | 14225 Dedeaux Rd, Gulfport, MS 39503-3369 | 2020-10-26 |
| 1285233452 | Darlene Johnson | Nurse Practitioner | 2808 Allyson Gene Cv, Byhalia, MS 38611-7359 | 2020-10-20 |
| 1447857073 | Clarissa Nicole Yarborough | Nurse Practitioner | 113 Saint John Rd, Tylertown, MS 39667-7927 | 2020-10-06 |
| 1922615616 | Jack Chandler Papa | Nurse Practitioner | 3556 May Brook Cv, Southaven, MS 38672-1006 | 2020-09-26 |
| 1205443165 | Mallory Stockstill | Nurse Practitioner | 27 Tillery Pl, Ellisville, MS 39437-4784 | 2020-09-24 |
| 1184230898 | Evelyn Michelle Rainey | Nurse Practitioner | 271 Eskridge Road, Duck Hill, MS 38925 | 2020-09-17 |
| Find all providers with the same taxonomy | ||||
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| 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.