Nicole D Bullock, LBWMT is a
Massage Therapist based in Mequon, Wisconsin. Nicole D Bullock is licensed to practice in Wisconsin (license number 12824-146) and her current practice location is
10303 N Port Washington Rd Ste 102, Mequon, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(262) 505-7950.
NPI number for Nicole D Bullock is 1023604048 and her current mailing address is W140n11945 Country Aire Dr, Germantown, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1023604048.
Healthcare Provider's Profile
Full Name | Nicole D Bullock |
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Gender | Female |
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Speciality | Massage Therapist |
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Location | 10303 N Port Washington Rd Ste 102, Mequon, Wisconsin |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1023604048
- Provider Enumeration Date: 12/14/2020
- Last Update Date: 12/14/2020
Medical Identifiers
Medical identifiers for Nicole D Bullock such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1023604048 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225700000X | Massage Therapist | 12824-146 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicole D Bullock is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Nicole D Bullock, LBWMT W140n11945 Country Aire Dr, Germantown, WI 53022-2700 Ph: (262) 505-7950 | Nicole D Bullock, LBWMT 10303 N Port Washington Rd Ste 102, Mequon, WI 53092-5760 Ph: (262) 505-7950 |
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