| NPI | 1164040036 |
|---|---|
| Former Name | KENNETH KEITH BULLINGTON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN238883) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA RN238883) |
| 163W00000X Registered Nurse (Licence: GA RN238883) | |
| 208M00000X Hospitalist (Licence: GA RN238883) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN238883) | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: GA RN238883) | |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2020-08-05 |