1. Home
  2. Directory
  3. Wisconsin
  4. Mequon
  5. Massage Therapist
  6. NPI Profile

NICOLE D BULLOCK LBWMT
NPI 1023604048
Massage Therapist in Mequon, WI

Active since December 14, 2020
10303 N PORT WASHINGTON RD STE 102, MEQUON, WI 53092(262) 505-7950 Get Directions Write a Review

NPPES record last updated: December 14, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nicole D Bullock Lbwmt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE D BULLOCK LBWMT (NPI 1023604048) is an individual massage therapist in Mequon, Wisconsin, licensed in Wisconsin (12824-146) and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1023604048
Entity TypeIndividualFemale
Primary Taxonomy225700000X
Provider Legal NameNICOLE D BULLOCKCredential: LBWMT
Location Address10303 N PORT WASHINGTON RD STE 102Mequon, WI 53092-5760
Mailing AddressW140n11945 Country Aire DrGermantown, WI 53022-2700 · (262) 505-7950
Phone(262) 505-7950
Sole ProprietorYes
Enumeration DateDecember 14, 2020
NPPES CertifiedDecember 14, 2020
✔ NPI 1023604048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in WI · 12824-146
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
10303 N PORT WASHINGTON RD STE 102, Mequon, WI 53092
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Bullock's NPI number?

The NPI number for Nicole Bullock is 1023604048. It was assigned to this individual provider in the NPPES registry on December 14, 2020.

Where is Nicole Bullock located?

Nicole Bullock practices at 10303 N Port Washington Rd Ste 102, Mequon, WI 53092. The listed phone number is (262) 505-7950.

What is Nicole Bullock's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Nicole Bullock was last updated on December 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.