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

Mrs. Kimberly Sue Ellen Bullard, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1003772211

Mrs. Kimberly Sue Ellen Bullard, FNP-BC is a Nurse Practitioner in Shallotte, North Carolina. Qualified in 2025, 1 year ago. Practices with Rdmg Associates PA, a 28-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
1
Licensed in
NC
In the registry since
2025
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

4503 Main St Ste 1
Shallotte, NC 28470-4583
Phone: (910) 754-2273
Fax: (910) 754-2254
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 5023712 (NC)

Record details

NPI number1003772211
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedDecember 31, 2025
Last updated in NPPESMay 5, 2026
Certification dateMay 5, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Rdmg Associates Pa — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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