Provider Demographics
NPI:1205501343
Name:BULLOCK, SARAH BETH (RN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:BULLOCK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:BETH
Other - Last Name:WILLIAMS ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1218 E ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-9224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2100 PRIMROSE ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-2211
Practice Address - Country:US
Practice Address - Phone:575-234-3303
Practice Address - Fax:575-200-3291
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS891705163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool