Provider Demographics
NPI:1417290685
Name:BULLARD, LYNN LEA (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:LEA
Last Name:BULLARD
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 W OAKLAWN RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78064-4033
Mailing Address - Country:US
Mailing Address - Phone:830-569-8940
Mailing Address - Fax:
Practice Address - Street 1:757 S PANNA MARIA AVE
Practice Address - Street 2:
Practice Address - City:KARNES CITY
Practice Address - State:TX
Practice Address - Zip Code:78118-3808
Practice Address - Country:US
Practice Address - Phone:830-780-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-05
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX558168363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily