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

Courtney Bullard, AGNP-C

Individual provider Gerontology Nurse Practitioner · NPI 1134772304

Courtney Bullard, AGNP-C is a Nurse Practitioner in Southaven, Mississippi. Qualified in 2019, 7 years ago. Practices with Wound Management Specialists LLC, a 158-clinician group. Licensed in Mississippi.

Years since qualifying
7
Licensed in
MS
In the registry since
2019
Specialties on file
2

Practice location Address checks out

60 Physicians Ln
Southaven, MS 38671-6122
Phone: (662) 688-5510
Show map & directions

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

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 903421 (MS)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 903421 (MS)

Record details

NPI number1134772304
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP-C
Sole proprietorNo
NPI enumeratedJuly 17, 2019
Last updated in NPPESJuly 19, 2024
Certification dateJuly 19, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Wound Management Specialists Llc — 158 clinicians
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

Other providers in Southaven