Provider Demographics
NPI:1063721223
Name:BULLINGTON, JOHN ANDREW JR (RN, ANP)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ANDREW
Last Name:BULLINGTON
Suffix:JR
Gender:M
Credentials:RN, ANP
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Mailing Address - Street 1:2304 WESVILL CT
Mailing Address - Street 2:SUITE 240
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-2973
Mailing Address - Country:US
Mailing Address - Phone:919-571-1567
Mailing Address - Fax:919-782-1472
Practice Address - Street 1:2304 WESVILL CT
Practice Address - Street 2:SUITE 240
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-2973
Practice Address - Country:US
Practice Address - Phone:919-235-1802
Practice Address - Fax:919-235-1354
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2024-12-30
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Provider Licenses
StateLicense IDTaxonomies
NC214130363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004581Medicaid