KATHLEEN BULLER NP NPI 1083623128

NPI Information

  • NPI: 1083623128
  • Provider Name: KATHLEEN BULLER, NP
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • Address: 730 GRANDVILLE AVE SW
    GRAND RAPIDS, MI
    ZIP 49503
  • Phone: (616) 913-8400

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NPI Details

Kathleen Buller, NP is a pediatrics nurse practitioner in Grand Rapids, MI. Kathleen Buller, NP NPI is 1083623128. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

730 GRANDVILLE AVE SW
GRAND RAPIDS, MI
ZIP 49503-920
Phone: (616) 913-8400
Fax: (616) 742-1322

The enumeration date for this NPI number is 8/7/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatrics4704096205MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14636819MEDICAIDMICHIGAN
2N26180013MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN
34925188MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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