National Provider Identifier
Leo Emmitt Bullard Jr.
Leo Emmitt Bullard Jr. is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (585) 490-6214.
Profile Overview
- NPI
- 1598125999
- Provider Type
- Individual
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- February 26, 2016
- Last Updated
- December 07, 2020
Practice Location
- 4581 Lake Ave
- Apt C
- Rochester, NY 14612-4528
Phone: (585) 490-6214
Specialties
- Licensed Practical Nurse (164W00000X)
Full Record
- NPI
- 1598125999
- Entity Type
- Individual
- Last Name
- Bullard
- First Name
- Leo
- Middle Name
- Emmitt
- Name Suffix
- Jr.
- Mailing Street Address
- 4581 Lake Ave
- Mailing Address Line 2
- Apt C
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14612-4528
- Mailing Country
- US
- Mailing Phone
- (585) 490-6214
- Practice Street Address
- 4581 Lake Ave
- Practice Address Line 2
- Apt C
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14612-4528
- Practice Country
- US
- Practice Phone
- (585) 490-6214
- Enumeration Date
- February 26, 2016
- Last Updated
- December 07, 2020
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- December 07, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Licensed Practical Nurse (164W00000X)