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BLAYNE BULLARD CM
>> Case Manager/Care Coordinator >> Other Service ProvidersRegistrant NPI Number: 1881883023
Individual Registrant: BLAYNE BULLARD CM
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
210 MANOR ST MARION, AR 72364-1936 US
Tel: 870-739-6818 Fax: 870-739-5852
Tel: 870-739-6818 Fax: 870-739-5852
Contact information for business:
210 MANOR ST MARION, AR 72364-1936 US
Tel: 870-739-6818 Fax: 870-739-1970
Tel: 870-739-6818 Fax: 870-739-1970
Registration Information:
NPI: 1881883023
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 171M00000X | Other Service Providers Case Manager/Care Coordinator |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
