Provider Demographics
NPI:1386729150
Name:BULL, ELINOR B (APRN BC)
Entity type:Individual
Prefix:MRS
First Name:ELINOR
Middle Name:B
Last Name:BULL
Suffix:
Gender:F
Credentials:APRN BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1104 KEA COURT
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560
Mailing Address - Country:US
Mailing Address - Phone:252-633-1229
Mailing Address - Fax:252-633-1229
Practice Address - Street 1:2807 NEUSE BLVD
Practice Address - Street 2:SUITE 10
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562
Practice Address - Country:US
Practice Address - Phone:252-636-2990
Practice Address - Fax:252-637-6011
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA00839051364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC86136F7Medicaid