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

Mrs. Kelly Michelle Bullock, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1720572225

Mrs. Kelly Michelle Bullock, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Lynchburg, Virginia. Qualified in 2018, 8 years ago. Practices with Granville Health System, a 80-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in North Carolina and Virginia.

Years since qualifying
8
Licensed in
NC, VA
In the registry since
2018
Specialties on file
3
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

See every abbreviation used in this directory →

Practice location Address checks out

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone: (704) 942-4854
Show map & directions

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

Additional practice locations (2)

  • 2301 Erwin Rd, Durham, NC 27705-4699 — (704) 942-4854
  • 601 N Elm St, High Point, NC 27262-4331 — (336) 878-6000

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 5919 (NC)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 121741 (NC)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 0024181581 (VA)

Record details

NPI number1720572225
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNA
Sole proprietorNo
NPI enumeratedJune 18, 2018
Last updated in NPPESMarch 3, 2026
Certification dateMarch 3, 2026

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Granville Health System — 80 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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