Provider Demographics
NPI:1548155146
Name:BULLOCK, BRIANNA (DNP, APRN, AGACNP-BC)
Entity type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:
Last Name:BULLOCK
Suffix:
Gender:F
Credentials:DNP, APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1273 LECOMTE RD
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-4320
Mailing Address - Country:US
Mailing Address - Phone:931-628-4361
Mailing Address - Fax:931-628-4361
Practice Address - Street 1:1273 LECOMTE RD
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-4320
Practice Address - Country:US
Practice Address - Phone:931-628-4361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN244432163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse