Mrs Tara Lea Bullock, ANP is a
Nurse Practitioner - Family based in London, Arkansas. Mrs Tara Lea Bullock is licensed to practice in Arkansas (license number A01514) and her current practice location is
Rr 1 Box 371a, London, Arkansas. She can be reached at her office (for appointments etc.) via phone at
(479) 968-1245.
NPI number for Mrs Tara Lea Bullock is 1063410710 and her current mailing address is Rr 1 Box 371a, London, Arkansas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1063410710.
Provider's Profile
Full Name | Mrs Tara Lea Bullock |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | Rr 1 Box 371a, London, Arkansas |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1063410710
- Provider Enumeration Date: 07/07/2005
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mrs Tara Lea Bullock such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1063410710 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | A01514 (Arkansas) | 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. Mrs Tara Lea 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 |
Mrs Tara Lea Bullock, ANP Rr 1 Box 371a, London, AR 72847-9602 Ph: (479) 968-1245 | Mrs Tara Lea Bullock, ANP Rr 1 Box 371a, London, AR 72847-9602 Ph: (479) 968-1245 |
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