Provider Demographics
NPI:1851838338
Name:BULIN, MELISSA (MS, ATC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BULIN
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2191 ROAD 6100
Mailing Address - Street 2:
Mailing Address - City:BRUNING
Mailing Address - State:NE
Mailing Address - Zip Code:68322-4021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2191 ROAD 6100
Practice Address - Street 2:
Practice Address - City:BRUNING
Practice Address - State:NE
Practice Address - Zip Code:68322
Practice Address - Country:US
Practice Address - Phone:402-768-8836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-23
Last Update Date:2018-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
2000031109OtherBOC