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Contact Information

MICHELLE A COLLERAN BULLOCK, REGISTERED NURSE
3010 CHISHOLM DR
HAGERMAN, ID83332-6056
 Phone: 208-339-5980
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for MICHELLE A COLLERAN BULLOCK · (Female)

NPI # 1376364166
Status Active
Credentials REGISTERED NURSE
Entity Individual
Enumeration date 10/23/2024
Last updated 10/23/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • ID License # N-26179
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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