Individual provider Active NPI

Nina Bullard, CRNA

  • Certified Registered Nurse Anesthetist
  • Stoughton, MA
National Provider Identifier
1689649162
Registry record updated Jun 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
177616 Issued in MA
Practice address
907 Sumner St
Suite M 201
Stoughton, MA 02072
Phone
(781) 344-2325
Fax
(781) 341-8544
NPI assigned
Feb 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 177616 MA Primary

Addresses

Primary practice location

907 Sumner St
Suite M 201
Stoughton, MA 02072

Mailing address

907 Sumner St
Suite M 201
Stoughton, MA 02072-3374
Phone (781) 344-2325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
177616MAMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1689649162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 SUMNER ST",
            "address_2": "SUITE M 201",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020723374",
            "telephone_number": "781-344-2325",
            "fax_number": "781-341-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 SUMNER ST",
            "address_2": "SUITE M 201",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "02072",
            "telephone_number": "781-344-2325",
            "fax_number": "781-341-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "NINA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "177616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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.