Provider Demographics
NPI:1659372134
Name:BULL, JULIA KATHLEEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:KATHLEEN
Last Name:BULL
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 1:100 ASMA BLVD
Mailing Address - Street 2:BLDG 1, SUITE 205
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3858
Mailing Address - Country:US
Mailing Address - Phone:337-289-5605
Mailing Address - Fax:337-289-5609
Practice Address - Street 1:100 ASMA BLVD
Practice Address - Street 2:BLDG 1, SUITE 205
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3858
Practice Address - Country:US
Practice Address - Phone:337-289-5605
Practice Address - Fax:337-289-5609
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP03865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1187712Medicaid
LA1187712Medicaid
LA4B807Medicare ID - Type Unspecified