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Contact Information

TARA L BULLOCK, ANP
RR 1 BOX 371A
LONDON, AR72847-9602
 Phone: 479-968-1245
 Fax: 479-968-4137
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for TARA L BULLOCK · (Female)

NPI # 1063410710
Status Active
Credentials ANP (Adult Nurse Practitioner)
Entity Individual
Enumeration date 07/07/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • AR License # A01514
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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