Stephen D Bullock, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

375742-4405 Issued in UT

Practice address

441 S Redwood Rd
Salt Lake City, UT 84104-3539

Phone

(801) 294-6907

Fax

(801) 294-6917

NPI assigned

Jun 25, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1073995072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "801-294-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 S REDWOOD RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841043539",
            "telephone_number": "801-294-6907",
            "fax_number": "801-294-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "STEPHEN",
        "middle_name": "D",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-25",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "375742-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Buller
• Robert Austin Bulloch, LCSW
• Colby Dee Bullock, DPT
• Hunter Bullock, MLS(ASCP)
• Shane Bullock
• Emily Megan Bullough
• Timothy Stephen Bump
• Chelsy Jane Bundy, LAMFT
• Brooke Bunkall, APRN
• David D. Bunker, MD

• Family Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.