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General NPI Number Information
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NPI Number | 1538000682
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Entity Type | Individual
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Provider Name | JILLIAN MARIE BULLOCK FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 78 SUTTON AVE
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City | OXFORD
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State | MA
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Zip | 01540-1813
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Country | US
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Telephone | 508-499-1760
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Fax |
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Provider Business Mailing Address
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Address Line | 53 S SPENCER RD
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City | SPENCER
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State | MA
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Zip | 01562-2629
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Country | US
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Telephone | 508-847-7513
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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 | RN2308629
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License Number State | MA
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