Bobbi Annette Bullock, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP-879A Issued in ID

Practice address

1611 12TH Ave Rd
Suite a
Nampa, ID 83686-7715

Phone

(208) 468-9400

NPI assigned

Sep 4, 2008

Last updated

Jan 23, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Bobbi Annette Kern Former name

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": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1669620506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 12TH AVE RD",
            "address_2": "SUITE A",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836867715",
            "telephone_number": "208-468-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 12TH AVE RD",
            "address_2": "SUITE A",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836867715",
            "telephone_number": "208-468-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "BOBBI",
        "middle_name": "ANNETTE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-879A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOBBI",
            "last_name": "KERN",
            "middle_name": "ANNETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Camille Buchmiller Buchmiller, PA
• Jeffrey Buckingham
• Mikaela Rae Buckley
• Joseph Bugher, MS LPC
• Ladonna Bullis
• Shannon F Burbank
• Brandy D Burch
• Joel J Burch, PA
• Kira Jean Burgess-Elmer, LCPC
• Phillip Neil Burk, D.P.M.

• Family Nurse Practitioner in Nampa, ID
• Providers in Nampa, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.