Bulkley, Kristin Marie

Bulkley, Kristin Marie is an individual health care provider with primary practice located at 15728 S Route 59 , Plainfield IL 60544-2693. She recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutritionist, Dietary & Nutritional Service Providers / Dietitian, Registered. Dietary & Nutritional Service Providers / Dietitian, Registered is her primary health care specialty. Bulkley, Kristin Marie can be contacted via phone (815) 436-8831.

Contact Information

Primary practice address
15728 S Route 59 Plainfield IL 60544-2693
Phone: (815) 436-8831
Fax: (815) 436-6863
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutritionist 133N00000X 164004687 Illinois
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 164004687 Illinois

Profile Details

NPI number 1710179544
LBN Legal business name Bulkley, Kristin Marie
Credentials R.D, L.D.N
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2007
Last updated May 20th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710179544 NPPES
Illinois MEDICAID 164004687
Illinois Other P00186793

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