Provider Demographics
NPI:1720157589
Name:BULS, PATRICIA E (APRN BC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:E
Last Name:BULS
Suffix:
Gender:F
Credentials:APRN BC
Other - Prefix:
Other - First Name:TRISH
Other - Middle Name:
Other - Last Name:BULS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN BC
Mailing Address - Street 1:460 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240
Mailing Address - Country:US
Mailing Address - Phone:207-782-5731
Mailing Address - Fax:207-784-2232
Practice Address - Street 1:460 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240
Practice Address - Country:US
Practice Address - Phone:207-782-5731
Practice Address - Fax:207-784-2232
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2012-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNS84136364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME431839500Medicaid
ME047821OtherANTHEM BLUE CROSS
ME7460667OtherAETNA
ME7460667OtherAETNA