MEDICARE: ASHLEY NOEL MULLINEAUX

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1407155823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY NOEL MULLINEAUX

Provider Business Mailing Address
First Line	:	3725 W 4100 S STE 150
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-5411
Country	:	US
Telephone Number	:	801-582-5534
Fax Number	:	801-582-5540

Provider Business Practice Location Address
First Line	:	3725 W 4100 S STE 150
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-5411
Country	:	US
Telephone Number	:	801-582-5534
Fax Number	:	801-582-5540

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2011
Last Update Date	:	03/10/2026

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