Eleanor Bullock

Individual provider Active NPI Nurse Practitioner · Covington, KY

NPI 1902777477 · NPPES record last updated Sep 16, 2025

Key facts

NPI
1902777477
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
APRN.CNP.0040298 (OH)
Practice address
322 Greenup St
Covington, KY 41011-1755
Phone
(859) 365-3300
NPI assigned
Sep 16, 2025
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)
No

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0040298OHMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363L00000X APRN.CNP.0040298 OH Yes

Addresses

Primary practice location

322 Greenup St
Covington, KY 41011-1755

Mailing address

202 Athey St
Covington, KY 41011-2323
Phone (614) 557-1373

Other providers in Covington, KY

All providers in Covington, KY · Nurse Practitioner in Kentucky

Sources for this page

Verify at the official NPI Registry.