KELLY BULLARD (NPI# 1831726975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831726975 |
| Entity Type | Individual |
| Full Name | KELLY BULLARD |
| Credential | DO |
| Practice Address |
1601 Owen Dr Fayetteville NC 28304-3425 |
| Practice Telephone | 9106780100 |
| Mailing Telephone | 9106780100 |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2020-03-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1601 OWEN DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-3425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902891450 | Phyllis K Marion | Nurse Practitioner | 1601 Owen Dr, Sr-ahec Specialty Medical Center, Fayetteville, NC 28304-3425 | 2005-09-12 |
| 1811525322 | Zanetta Batts | Student in an Organized Health Care Education/Training Program | 1601 Owen Dr, Fayetteville, NC 28304-3425 | 2020-03-30 |
| 1669009171 | Jason Alexander Cooper | Student in an Organized Health Care Education/Training Program | 1601 Owen Dr, Fayetteville, NC 28304-3425 | 2020-03-25 |
| 1568099208 | Daisy Kwende | Student in an Organized Health Care Education/Training Program | 1601 Owen Dr, Fayetteville, NC 28304-3425 | 2020-03-24 |
| 1043847536 | Dorian Christine Bonam | Student in an Organized Health Care Education/Training Program | 1601 Owen Dr, Fayetteville, NC 28304-3425 | 2020-03-24 |
| 1477180206 | Benison Mangel | Student in an Organized Health Care Education/Training Program | 1601 Owen Dr, Fayetteville, NC 28304-3425 | 2020-03-23 |
| 1770110512 | Jimmy Pan | Student in an Organized Health Care Education/Training Program | 1601 Owen Dr, Fayetteville, NC 28304-3425 | 2020-03-23 |
| 1255967113 | Leah Bryan | Student in an Organized Health Care Education/Training Program | 1601 Owen Dr, Fayetteville, NC 28304-3425 | 2020-03-22 |
| 1134680325 | Erin Olivia Clark | Student in an Organized Health Care Education/Training Program | 1601 Owen Dr, Fayetteville, NC 28304-3425 | 2019-03-29 |
| 1033670237 | Nikhil R Gupta | Student in an Organized Health Care Education/Training Program | 1601 Owen Dr, Fayetteville, NC 28304-3425 | 2019-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588276471 | Henrietta Elise Mckoy | Student in an Organized Health Care Education/Training Program | 913 Liberty Ln, Fayetteville, NC 28311-3073 | 2020-08-20 |
| 1346869567 | Sahiba Bajwa | Student in an Organized Health Care Education/Training Program | Uams Northwest Campus, 1125 N. College Avenue, Slot 100, Fayetteville, AR 72703-1908 | 2020-04-09 |
| 1982239463 | Ashley A Bethea | Student in an Organized Health Care Education/Training Program | 4422 Spinel Dr, Fayetteville, NC 28311-6862 | 2020-03-05 |
| 1730719329 | Jessica Claire Perrett | Student in an Organized Health Care Education/Training Program | 150 Oak Shadow Way, Fayetteville, GA 30215-2985 | 2020-01-22 |
| 1215579263 | Hallie Hawe | Student in an Organized Health Care Education/Training Program | 2084 N Chestnut Ave Apt 13, Fayetteville, AR 72703-2242 | 2019-10-10 |
| 1457992877 | Daniel Ross Barber | Student in an Organized Health Care Education/Training Program | 503 Blessings Hill Ln, Fayetteville, TN 37334-9710 | 2019-10-07 |
| 1982160982 | Timothy Glenn Higgins | Student in an Organized Health Care Education/Training Program | 1689 N Whistling Straits Ave Apt 301, Fayetteville, AR 72704-6679 | 2019-02-14 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1053821165 | Yancy T. Dials | Student in an Organized Health Care Education/Training Program | 340 Ridgemont Dr, Fayetteville, GA 30215-7708 | 2017-10-03 |
| 1881128601 | Cynthia Jackson | Student in an Organized Health Care Education/Training Program | 5100 Highbridge St Apt 47d, Fayetteville, NY 13066-2461 | 2017-04-18 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on KELLY BULLARD.
| 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.