Amanda Bullock, RN

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

258475-30 Issued in WI

Practice address

611 Two Mile Ave
Wisconsin Rapids, WI 54494-6560

Phone

(715) 424-6793

Fax

(715) 424-6794

NPI assigned

May 13, 2026

Last updated

May 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1778630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1669300125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 TWO MILE AVE",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544946560",
            "telephone_number": "715-424-6793",
            "fax_number": "715-424-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 TWO MILE AVE",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544946560",
            "telephone_number": "715-424-6793",
            "fax_number": "715-424-6794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 8th St N",
            "address_purpose": "LOCATION",
            "city": "Wisconsin Rapids",
            "state": "WI",
            "postal_code": "544944488",
            "country_code": "US",
            "telephone_number": "715-424-6772",
            "fax_number": "715-424-6773",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "471 Grove Ave",
            "address_purpose": "LOCATION",
            "city": "Wisconsin Rapids",
            "state": "WI",
            "postal_code": "544946279",
            "country_code": "US",
            "telephone_number": "715-424-6769 x2108",
            "fax_number": "715-424-6770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 17th St S",
            "address_purpose": "LOCATION",
            "city": "Wisconsin Rapids",
            "state": "WI",
            "postal_code": "544945106",
            "country_code": "US",
            "telephone_number": "715-424-6779",
            "fax_number": "715-424-6780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2911 Washington St",
            "address_purpose": "LOCATION",
            "city": "Wisconsin Rapids",
            "state": "WI",
            "postal_code": "544941602",
            "country_code": "US",
            "telephone_number": "715-424-6788",
            "fax_number": "715-424-6789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6950 Knowledge Ave",
            "address_purpose": "LOCATION",
            "city": "Rudolph",
            "state": "WI",
            "postal_code": "544759729",
            "country_code": "US",
            "telephone_number": "715-424-6784",
            "fax_number": "715-424-6785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "241 17th Ave S",
            "address_purpose": "LOCATION",
            "city": "Wisconsin Rapids",
            "state": "WI",
            "postal_code": "544952408",
            "country_code": "US",
            "telephone_number": "715-424-6777",
            "fax_number": "715-424-6778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "AMANDA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-13",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "WI",
            "license": "258475-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory F Broyles, PA-C
• Scott Francis Bruneau, O.D.
• Linda Buchs-Hammonds, M.S.W., L.C.S.W.
• Jordan Bui
• Heidi J Bulgrin
• Nicole L Burlingame
• Mackenzie Buttles, OTR/L
• Jessica Lynn Cahill, PA
• Tonya Lyn Krueger Callahan, MS CRC LPC
• Carlson Gi Clinic

• School Registered Nurse in Wisconsin Rapids, WI
• Providers in Wisconsin Rapids, WI by specialty
• School Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.