Brittany Ann Bullock, DNP, APRN, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Tooele, UT
NPI 1841983103 · NPPES record last updated Jul 7, 2023
Key facts
- NPI
- 1841983103
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 7313239-4405 (UT)
- Practice address
- 28 N Main St Ste 3
Tooele, UT 84074-2352 - Phone
- (435) 830-7170
- NPI assigned
- Jun 1, 2023
- 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)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7313239-4405 | UT | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse |
163WP0808X | 7313239-3102 | UT | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 7313239-4405 | UT | Yes |
Addresses
Primary practice location
28 N Main St Ste 3
Tooele, UT 84074-2352
Mailing address
365 S Canyon Overlook Dr
Tooele, UT 84074-3518
Phone (435) 830-7170
Other providers in Tooele, UT
- Shelly Ann Brown
- Peter Browne
- Steven C Bruderer
- Bennion Buchanan
- Miriam Eileen Buell
- Alexandria Burringo
- Rachelle Busico
- April Alice Butler
- Rita Josephine Butler
- John Patrick Byrne
All providers in Tooele, UT · Psychiatric/Mental Health Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2023. 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.