AMBER BULLOCK
NPI 1417880824
Student in an Organized Health Care Education/Training Program in Augusta, GA

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since June 05, 2026

1120 15TH ST, AUGUSTA, GA 30912(678) 709-7438 Get Directions Write a Review

NPPES record last updated: June 18, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Amber Bullock NPPES

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

AMBER BULLOCK (NPI 1417880824) is an individual student in an organized health care education/training program in Augusta, Georgia, licensed in Georgia (113754) and active in the NPI registry since June 2026.

NPPES Registry Identity

NPI1417880824

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameAMBER BULLOCK

Location Address1120 15TH STAugusta, GA 30912-0006

Mailing Address1040 Alexander Dr Apt 6222Augusta, GA 30909-0288

Phone(678) 709-7438

Sole ProprietorYes

Enumeration DateJune 5, 2026

Last NPPES UpdateJune 18, 2026

NPPES CertifiedJune 18, 2026

✔ NPI 1417880824 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in GA · 113754

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1120 15TH ST, Augusta, GA 30912

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