Provider Demographics
NPI:1720627102
Name:BULLINGER, CHRISTINE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:BULLINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4245 ROAD 10 1/2
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WY
Mailing Address - Zip Code:82411-9750
Mailing Address - Country:US
Mailing Address - Phone:307-272-4617
Mailing Address - Fax:
Practice Address - Street 1:4245 ROAD 10 1/2
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WY
Practice Address - Zip Code:82411-9750
Practice Address - Country:US
Practice Address - Phone:307-272-4617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator