Michelle Angelique Colleran Bullock, REGISTERED NURSE

NPI #1376364166 in Hagerman, Idaho

Provider Information

NPI Number: 1376364166
Entity Type: Individual
Name: Michelle Angelique Colleran Bullock, REGISTERED NURSE
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Registered Nurse
Credential: REGISTERED NURSE
Enumeration Date: Oct 23, 2024
Last Updated: Oct 23, 2024

Practice Location

Address: 3010 CHISHOLM DR
City: Hagerman
State: Idaho
ZIP Code: 83332-6056
Phone: (208) 339-5980

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X	Primary

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