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NPI Code Detail

MEDICARE: ROWENA O BULLEN NP

MEDICARE: ROWENA O BULLEN NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP113552TX
2363L00000XNurse PractitionerAP113552TX

General Provider Information

NPI Number : 1407840507
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROWENA O BULLEN NP
Provider Business Mailing Address
First Line : PO BOX 5718
Second Line :
City : NORMAN
State : OK
Zip : 73070-5718
Country : US
Telephone Number : 866-321-8433
Fax Number :
Provider Business Practice Location Address
First Line : 2200 W ILLINOIS AVE
Second Line :
City : MIDLAND
State : TX
Zip : 79701-6407
Country : US
Telephone Number : 432-685-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2005
Last Update Date : 03/27/2023

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