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General NPI Number Information
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NPI Number | 1366224578
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Entity Type | Individual
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Provider Name | CHRISTINA BULASKI
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Gender | Female
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Dates
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Enumeration Date | 10/23/2023
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 11835 HAZEL CIRCLE DR
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City | BRISTOW
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State | VA
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Zip | 20136-1223
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Country | US
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Telephone | 757-685-4150
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Fax |
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Provider Business Mailing Address
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Address Line | 11835 HAZEL CIRCLE DR
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City | BRISTOW
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State | VA
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Zip | 20136-1223
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Country | US
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Telephone | 703-659-0855
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 001213640
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 0001213640
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License Number State | VA
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