Kristi A Bullock, PA
Physician Assistant in Davenport, IA. Individual provider (NPI-1).
NPI number1760458178
StatusActive
Last updated in NPPESOct 6, 2017
Details
- NPI
- 1760458178
- Entity type
- Individual (NPI-1)
- Name
- Kristi A Bullock
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 24, 2006
- Last updated
- Oct 6, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 001204 | IA | Yes |
Practice location
5350 Eastern Ave.Davenport, IA 52807-2709
Phone 563-355-1853 · Fax 563-359-1512
Mailing address
5350 Eastern Ave.Davenport, IA 52807-2709
Phone 563-355-1853 · Fax 563-359-1512
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All 78 Physician Assistant providers in Davenport · All 2,731 providers in Davenport
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