Search › Idaho › 207Q00000X
Shay Bullock, NP-C
NPI 1366101743 · on the registry since 2021
Practice
- Address
- 33 N. Mission Rd
Fort Hall, ID 83203 - Phone
- (208) 380-9727
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Licence states on file
- NV
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-07-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho