Josephine L Bullock, RN
Individual provider Active NPI Home Health Registered Nurse · Detroit, MI
NPI 1124175526 · NPPES record last updated Jul 16, 2007
Key facts
- NPI
- 1124175526
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Registered Nurse 163WH0200X
- License
- 4704095091 (MI)
- Practice address
- 4646 John R St
C1831
Detroit, MI 48201-1916 - Phone
- (313) 576-4431
- Fax
- (313) 576-1812
- NPI assigned
- Jan 5, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704095091 | MI | MD | Home Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 4704095091 | MI | Yes |
Addresses
Primary practice location
4646 John R St
C1831
Detroit, MI 48201-1916
Mailing address
4646 John R St
C1831
Detroit, MI 48201-1916
Phone (313) 576-4431
Other providers in Detroit, MI
- Maria Demma Buison
- Samreen Bukhari
- Bisena Bulica
- Asya Bullard
- Nevaeh Skye Bullitt
- Kim D Bullock
- Kyle Jahmal Bullock
- Angela Bully
- Connor Matthew Bunch
- Tiye Bundles
All providers in Detroit, MI · Home Health Registered Nurse in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.