Provider Demographics
NPI:1477946051
Name:BULGRIEN, LINDSEY (NP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:BULGRIEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3559 PINE ST
Mailing Address - Street 2:PO BOX 126
Mailing Address - City:DECKERVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48427-7703
Mailing Address - Country:US
Mailing Address - Phone:810-376-2885
Mailing Address - Fax:810-376-9412
Practice Address - Street 1:2433 BLACK RIVER ST
Practice Address - Street 2:
Practice Address - City:DECKERVILLE
Practice Address - State:MI
Practice Address - Zip Code:48427-9425
Practice Address - Country:US
Practice Address - Phone:810-376-2885
Practice Address - Fax:810-376-8301
Is Sole Proprietor?:No
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704253199363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily