Basic Information
| Provider Information | |||||||||
| NPI: | 1699155309 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BULLINS | ||||||||
| FirstName: | BRITTNI | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 601791 | ||||||||
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| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282601791 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1730 KERNERSVILLE MEDICAL PKWY STE 201 | ||||||||
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| City: | KERNERSVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272847198 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3369967001 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2015 | ||||||||
| LastUpdateDate: | 10/07/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 11392 | NC | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.