Darci Bullock, LPN
Individual provider Active NPI Licensed Practical Nurse · Niles, MI
NPI 1417337262 · NPPES record last updated Jun 8, 2015
Key facts
- NPI
- 1417337262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 4703099274 (MI)
- Practice address
- 1638 Superior St
Niles, MI 49120-3817 - Phone
- (269) 845-0032
- NPI assigned
- Jun 8, 2015
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4703099274 | MI | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703099274 | MI | Yes |
Addresses
Primary practice location
1638 Superior St
Niles, MI 49120-3817
Mailing address
1638 Superior St
Niles, MI 49120-3817
Phone (269) 845-0032
Other providers in Niles, MI
- Robert Britton
- Samantha Brousseau
- Aaron M Brown
- Natalie Nicole Brown
- Seth Buchanan
- John S Burgess
- Melissa Burpee
- Melinda Bush
- Calm Lake Counseling, PLLC
- Joseph Houston Capps
All providers in Niles, MI · Licensed Practical 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 Jun 8, 2015. 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.