Provider Demographics
NPI:1013518653
Name:BULLARD, RACHELLE ANNE TORRES (RN)
Entity Type:Individual
Prefix:
First Name:RACHELLE ANNE
Middle Name:TORRES
Last Name:BULLARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8930 MAYHEW CT
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4722
Mailing Address - Country:US
Mailing Address - Phone:813-758-3708
Mailing Address - Fax:
Practice Address - Street 1:8930 MAYHEW CT
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4722
Practice Address - Country:US
Practice Address - Phone:915-549-1033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001286160163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical