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NPI Code Detail

MEDICARE: MRS. LYNN LEA BULLARD FNP-BC

MEDICARE: MRS. LYNN LEA BULLARD FNP-BC
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 Practitioner558168TX

General Provider Information

NPI Number : 1417290685
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LYNN LEA BULLARD FNP-BC
Provider Business Mailing Address
First Line : 310 W OAKLAWN RD
Second Line :
City : PLEASANTON
State : TX
Zip : 78064-4033
Country : US
Telephone Number : 830-569-8940
Fax Number :
Provider Business Practice Location Address
First Line : 757 S PANNA MARIA AVE
Second Line :
City : KARNES CITY
State : TX
Zip : 78118-3808
Country : US
Telephone Number : 830-780-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2013
Last Update Date : 02/10/2026

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