Doctor Name: | ALESSANDRA MARIE BULLIS |
NPI Number: | 1093174930 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 0177189 |
Business Practice Address: | 16420 W Us Highway 24 Woodland Park, CO - 808638760 |
Business Phone Number: | 7203090464 |
Business Fax Number: | |
Mailing Address: | Po Box 1059, FLORISSANT |
State: | CO |
Postal Code: | 808161059 |
Phone Number: | 7196892511 |
Fax Number: | |
NPI Enumeration Date: | 02/21/2016 |
NPI Last Update Date: | 02/21/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 0177189 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |