Individual provider · NPI-1

Tara Bullock

Licensed Practical Nurse · Wilmington, DE

NPI number1427943463
StatusActive
Last updated in NPPESJun 10, 2025

Details

NPI
1427943463
Entity type
Individual (NPI-1)
Name
Tara Bullock
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 10, 2025
Certification date
Jun 10, 2025
Last updated
Jun 10, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
164W00000X Licensed Practical Nursel2-0007255DEYes

Other names

  • Tara Lowe (Former Name)

Practice location

501 W 39th St
Wilmington, DE 19802-2117

Phone 302-588-6566

Mailing address

501 W 39th St
Wilmington, DE 19802-2117

Phone 302-588-6566

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