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General NPI Number Information
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NPI Number | 1376022400
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Entity Type | Individual
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Provider Name | NICOLE MARIE BULMAN RDN
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Gender | Female
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Dates
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Enumeration Date | 08/09/2018
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 6161 S. YALE AVE
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City | TULSA
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State | OK
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Zip | 74136
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Country | US
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Telephone | 918-494-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 7622 E. 58TH PL.
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City | TULSA
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State | OK
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Zip | 74145
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Country | US
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Telephone | 918-406-0192
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86100128
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 2310
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License Number State | OK
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