Provider Demographics
NPI:1811940059
Name:BULLER, CAROL ANN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANN
Last Name:BULLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9100 PARK STREET
Mailing Address - Street 2:SUITE 202B
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-3374
Mailing Address - Country:US
Mailing Address - Phone:913-438-4286
Mailing Address - Fax:913-438-9076
Practice Address - Street 1:9100 PARK STREET
Practice Address - Street 2:SUITE 202B
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3374
Practice Address - Country:US
Practice Address - Phone:913-438-4286
Practice Address - Fax:913-438-9076
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44790363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
26278011OtherBCBS
26278011OtherBCBS
S61589Medicare UPIN