Provider Demographics
NPI:1578994083
Name:BULLARD, KARI LYNN (NP-C)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:LYNN
Last Name:BULLARD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-4200
Mailing Address - Country:US
Mailing Address - Phone:940-549-7741
Mailing Address - Fax:940-549-6265
Practice Address - Street 1:820 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-4200
Practice Address - Country:US
Practice Address - Phone:940-549-7741
Practice Address - Fax:940-549-6265
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX624760363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily