NPI 1891706412 · live from the CMS NPI Registry
Susan Kristine Bullano, O.D.
Optometrist in Mission, KS. National Provider Identifier 1891706412, active.
NPI record
| NPI | 1891706412 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 6120 Johnson Dr, Mission, KS 66202 |
| Practice phone | 913-262-3937 |
| Mailing address | 13385 Sycamore Dr, Platte City, MO 64079 |
| Enumerated | August 10, 2006 |
| Last updated | February 26, 2013 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 1858 (KS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.