MRS. THERESA SUE IGNACZAK BULLIS


Address: 4855 S Moorland Rd, New Berlin, WI 53151-7494
Phone: 2624327599

MRS. THERESA SUE IGNACZAK BULLIS (NPI# 1871041996) 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) 1871041996
Entity Type Individual
Full Name MRS. THERESA SUE IGNACZAK BULLIS
Credential CPNP-PC
Practice Address 4855 S Moorland Rd
New Berlin
WI 53151-7494
Mailing Address 9000 W Wisconsin Ave # Ms 958
Milwaukee
WI 53226-4874
Practice Telephone 2624327599
Practice Fax Number 2624327694
Mailing Telephone 4142667615
Mailing Fax Number 4142666238
Enumeration Date 2016-09-18
Last Update Date 2018-12-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
7248-33 WI Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
WI 1871041996 05

Office Location

Street Address 4855 S MOORLAND RD
City NEW BERLIN
State WI
Zip Code 53151-7494

Providers in the same location

NPI Name Taxonomy Address Enumeration
1649277278 Daniel Dorrington Pediatrics 4855 S Moorland Rd, Suite 150, New Berlin, WI 53151-7401 2005-06-28
1497226781 Brian Hoppe Pharmacist 4855 S Moorland Rd, New Berlin, WI 53151-7494 2018-12-11
1508229949 Eman Abdel-latief Pediatrics 4855 S Moorland Rd, New Berlin, WI 53151-7494 2016-04-02
1861863920 Molly Schuelke Physician Assistant 4855 S Moorland Rd, New Berlin, WI 53151-7494 2015-10-15
1700256781 Karla Michelle Quinones Audiologist 4855 S Moorland Rd, Suite 300, New Berlin, WI 53151-7494 2015-10-02
1104211416 Regina Shea Dalla Riva Pediatrics 4855 S Moorland Rd, New Berlin, WI 53151-7494 2015-04-02
1669861548 Davietta Butty Pediatrics 4855 S Moorland Rd, New Berlin, WI 53151 2015-01-15
1306253117 Elizabeth Frantal Physician Assistant 4855 S Moorland Rd, #150, New Berlin, WI 53151-7494 2014-07-14
1518371541 Chasity T Brimeyer Psychologist 4855 S Moorland Rd, Headache Clinic, New Berlin, WI 53151-7494 2014-06-18
1588082028 Apoorva Prasanna Murthy Pediatrics 4855 S Moorland Rd, New Berlin, WI 53151-7494 2014-04-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1629527486 Natural Look Salon and Wigs LLC Durable Medical Equipment & Medical Supplies 4805 S. Moorland Rd, New Berlin, WI 53151 2016-09-22
1396193033 New Berlin Medical Services, LLC Clinic/Center 15324 W Beloit Road, New Berlin, WI 53151 2016-06-02
1063899680 Costco Wholesale Corporation Eyewear Supplier (Equipment, not the service) 15300 West Grange Avenue, New Berlin, WI 53151 2015-05-04
1871970368 Mary Spath Physical Therapy Assistant 2810 South Acredale Road, New Berlin, WI 53151 2015-05-04
1669885471 Wauwatosa Prescription Center, Inc. Pharmacy 4855 S Moorland Road, New Berlin, WI 53151 2014-06-09
1750711446 Pure Family Chiropractic LLC Chiropractor 3504 S. Moorland Road, New Berlin, WI 53151 2013-11-18
1336578202 Hamilton John Dowden Chiropractor 3504 S Moorland Rd, New Berlin, WI 53151 2013-11-01
1053653618 Danielle Lynn Lucio Acupuncturist 15807 W. National Ave., New Berlin, WI 53151 2013-03-21
1306195110 Marlena J Friedrich Registered Nurse 1709 S. 171st Street, New Berlin, WI 53151 2012-09-07
1548519176 Patricia M Friedrich Licensed Practical Nurse 1709 So. 171st Street, New Berlin, WI 53151 2012-08-29
Find all providers in zip 53151

Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1639685274 Laura Palmer Nurse Practitioner 4855 S Moorland Rd # Rod, New Berlin, WI 53151-7494 2017-12-19
1689878092 Kathleen Trier Mcwey Nurse Practitioner 3610 Michelle Witmer Memorial Dr, New Berlin, WI 53151-5292 2007-06-12
1013525096 Katherine Ciminelli Waller Nurse Practitioner 4855 S Moorland Rd Fl 3, New Berlin, WI 53151-7494 2020-07-16
1881057065 Anna B Pokrzywinski Nurse Practitioner 4855 S Moorland Rd Fl 3, New Berlin, WI 53151-7494 2016-04-04
1922314269 Alisa A Nehls Nurse Practitioner 4855 S Moorland Rd, New Berlin, WI 53151 2010-08-24
1386979193 Julie Bolha Nurse Practitioner 4855 S Moorland Rd, New Berlin, WI 53151-7494 2009-10-13
1407966898 Jodi O Spahr Nurse Practitioner 4855 S Moorland Rd Ste 250, New Berlin, WI 53151-7494 2006-08-30
1205857364 Meghan C. Belongia Nurse Practitioner 4855 S Moorland Rd, New Berlin, WI 53151-7494 2006-07-22
1063466191 Julie Ann Averbeck Nurse Practitioner 4855 S Moorland Rd, Suite 150, New Berlin, WI 53151-7494 2006-05-22
1841242443 Jeanne E Conner Nurse Practitioner 4855 S Moorland Rd, Allergy and Immunology, New Berlin, WI 53151-7494 2006-05-16
Find all providers in NEW BERLIN

Competitor

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City NEW BERLIN
Zip Code 53151

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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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