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SHAY BULLOCK, NP-C
NP-C
Family Medicine Physician
NPI: 1366101743IndividualAccepts Medicare
Specialties, Licenses & Credentials
Family Medicine PhysicianPrimary
Family Medicine
Code: 207Q00000X
812099(NV)
CMS Specialties
PrimaryNURSE PRACTITIONER
Education
OTHER
Class of 2018
Contact & Hours
- Address
- 33 N. MISSION RD
FORT HALL, ID 83203 - Phone
- (208) 380-9727
Quick Facts
- NPI
- 1366101743
- Entity Type
- Individual
- Gender
- Male
- Medicare
- Accepted
- Specialties
- 1
- Locations
- 1
- Years in Practice
- 8
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