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Mary G Bullock, RN,CNP
Family Nurse Practitioner in Roseville, Minnesota
NPI 1205932902

Mary G Bullock is a Family Nurse Practitioner based in Roseville, MN and is specialized in Family. Mary G Bullock practices in Roseville, MN and has the professional credentials of RN,CNP. The NPI Number for Mary G Bullock is 1205932902 and holds a License No. R119074-4 (Minnesota).

The current practice location address for Mary G Bullock is 2845 Hamline Ave North, Roseville, MN and can be reached out via phone at 651-631-6100 and via fax at 651-631-6343.

Location: 2845 Hamline Ave North, Roseville, MN, 55113
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205932902
Provider Name
Mary G Bullock
Credential
RN,CNP
Provider Entity Type
Individual
Gender
Female
Address
2845 Hamline Ave North, Roseville, MN, 55113
Phone Number
651-631-6100
Fax Number
651-631-6343
Provider Enumeration Date
09/16/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6676570-0 05 MN
institution
Provider Business Practice Location Address Details
Address
2845 Hamline Ave North
City
Roseville
State
Minnesota
Zip
55113
Phone Number
651-631-6100
Fax Number
651-631-6343
person
Provider Business Mailing Address Details
Address
2845 Hamline Ave North
City
Roseville
State
Minnesota
Zip
55113
Phone Number
651-631-6100
Fax Number
651-631-6343
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
R119074-4 (Minnesota)
Definition
Definition to come...
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