LAURA RUTHVEN BULLOCH PNP
Individual Provider (NPI-1)
Active
Nurse Practitioner, Pediatrics
Provider Information
- NPI Number
1700289147- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PNP
- Status
- Active
Contact & Location
- Address
- 800 W MAIN ST, LAKE CITY, SC, 295604400
- Phone
- (843) 977-7337
- Fax
- (843) 956-5415
Specialties & Taxonomies
Nurse Practitioner, Pediatrics
Primary License: SC #19069