Provider Demographics
NPI:1336933241
Name:BOBBIE-GULLIFORD, KENDYL L (APN)
Entity type:Individual
Prefix:
First Name:KENDYL
Middle Name:L
Last Name:BOBBIE-GULLIFORD
Suffix:
Gender:
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 MOUNT RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-2826
Mailing Address - Country:US
Mailing Address - Phone:609-864-6679
Mailing Address - Fax:
Practice Address - Street 1:932 MOUNT RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON CITY
Practice Address - State:NJ
Practice Address - Zip Code:08016-2826
Practice Address - Country:US
Practice Address - Phone:609-864-6679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15311600363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner