Provider Demographics
NPI:1205204393
Name:BULKOWSKI, BRITTNEY LAVERNE (RN)
Entity Type:Individual
Prefix:MISS
First Name:BRITTNEY
Middle Name:LAVERNE
Last Name:BULKOWSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5321 KNOLLWOOD DR
Mailing Address - Street 2:APARTMENT #2
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-1618
Mailing Address - Country:US
Mailing Address - Phone:216-372-3501
Mailing Address - Fax:216-661-4445
Practice Address - Street 1:5321 KNOLLWOOD DR
Practice Address - Street 2:APARTMENT #2
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-1618
Practice Address - Country:US
Practice Address - Phone:216-372-3501
Practice Address - Fax:216-661-4445
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.409671163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse