Provider Demographics
NPI:1891081097
Name:BULLARD, CYRINA JADE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CYRINA
Middle Name:JADE
Last Name:BULLARD
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7899 WADSWORTH BLVD
Mailing Address - Street 2:T-0048
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-2107
Mailing Address - Country:US
Mailing Address - Phone:303-425-8722
Mailing Address - Fax:303-425-8722
Practice Address - Street 1:7899 WADSWORTH BLVD
Practice Address - Street 2:T-0048
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2107
Practice Address - Country:US
Practice Address - Phone:303-425-8722
Practice Address - Fax:303-425-8722
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-26
Last Update Date:2011-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14575183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist