| NPI | 1386051068 |
|---|---|
| Former Name | SARA BETH BULLOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008771) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3008771) |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2023-02-15 |