Provider Demographics
NPI:1508126194
Name:BULLOCK, JOCELYN (HHA)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:BULLOCK
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3416 25TH ST SE APT 24
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-1945
Mailing Address - Country:US
Mailing Address - Phone:240-351-0718
Mailing Address - Fax:
Practice Address - Street 1:3416 25TH ST SE APT 24
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-1945
Practice Address - Country:US
Practice Address - Phone:240-351-0718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide