Sabrina Bullock, L.M.
Individual provider Active NPI Midwife · Clarksville, VA
NPI 1396830956 · NPPES record last updated Nov 29, 2007
Key facts
- NPI
- 1396830956
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Midwife 176B00000X
- License
- 0129000011 (VA)
- Practice address
- 606 Virginia Avenue
Clarksville, VA 23927 - Phone
- (252) 432-0102
- Fax
- (252) 438-3735
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0129000011 | VA | MD | Midwife |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 0129000011 | VA | Yes |
Addresses
Primary practice location
606 Virginia Avenue
Clarksville, VA 23927
Mailing address
2383 Egypt MTN. Rd.
Kittrell, NC 27544-9603
Phone (252) 432-0102
Other providers in Clarksville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 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.