BRENT JAMES BULLOCK PMHNP APRN NPI 1649983198

NPI Information

NPI: 1649983198
Provider Name: BRENT JAMES BULLOCK, PMHNP, APRN
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
1125 W CENTER ST
OREM, UT
ZIP 84057
Phone: (801) 903-5903
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Brent James Bullock, PMHNP, APRN is a psychiatric/mental health nurse practitioner in Orem, UT. Brent James Bullock, PMHNP, APRN NPI is 1649983198. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1125 W CENTER ST
OREM, UT
ZIP 84057-207
Phone: (801) 903-5903
Fax: (801) 515-0935

The NPI 1649983198 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/29/2022 and was last updated on 11/28/2023.

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
1	163W00000X	Registered Nurse		8695221-3102	UTAH	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	8695221-4405	UTAH	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	8695221-8900	UTAH	Yes

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: 5/5/2024

NPI Synchronization or Removal

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