Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KELLY LEIGH BULLOCK, D.O.
Active Sole ProprietorDR. KELLY LEIGH BULLOCK, D.O. is a Family Medicine healthcare provider located in RANDOLPH, Nebraska. NPI 1407941057 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · RANDOLPH, NE
Registration Details
- NPI Number
- 1407941057
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 3, 2006 (19.678671644823 yrs)
- Last Updated
- Feb 15, 2022
- License
-
461 (NE)
- Sole Proprietor
- Yes
Practice Information
- Address
-
106 E WAYNE STRANDOLPH, NE, 687715300Browse NE providers · Browse ZIP 68771
- Phone
- 4023370200
- Fax
- 4023371020
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in RANDOLPH, NE
| Name | Credential | NPI |
|---|---|---|
| DR. DAVID MWEBE | M.D. | 1609969476 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.