Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blake David Bulger

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1861101586

Blake David Bulger is a Nurse Practitioner in Barling, Arkansas. Qualified in 2023, 3 years ago. Practices with Ketamine and IV Therapy Clinic of Nwa LLC, an 11-clinician group and offers telehealth. Licensed in Arkansas and Oklahoma.

Years since qualifying
3
Licensed in
AR, OK
In the registry since
2022
Specialties on file
2

Practice location Address checks out

10301 Mayo Dr
Barling, AR 72923-1660
Phone: (479) 494-5700
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 226137 (AR)
Registered Nurse Taxonomy 163W00000X · Licence 206761 (OK)

Record details

NPI number1861101586
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 21, 2022
Last updated in NPPESSeptember 20, 2023
Certification dateSeptember 19, 2023
Mailing address10301 Mayo Dr, Barling, AR 72923-1660

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Ketamine And Iv Therapy Clinic Of Nwa Llc — 11 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Barling