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NPI Code Detail

MEDICARE: HOLLY KAREN MULLINS

MEDICARE: HOLLY KAREN MULLINS
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
1363LF0000XFamily Nurse Practitioner4051971KY
2363LF0000XFamily Nurse Practitioner3002788AL
3363LF0000XFamily Nurse Practitioner1017778TX
4363LF0000XFamily Nurse Practitioner2026000342MO

General Provider Information

NPI Number : 1457940827
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY KAREN MULLINS
Provider Business Mailing Address
First Line : 5450 CLEARFORK MAIN ST STE 300
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-3514
Country : US
Telephone Number : 817-334-1400
Fax Number : 817-334-1410
Provider Business Practice Location Address
First Line : 5450 CLEARFORK MAIN ST STE 300
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-3514
Country : US
Telephone Number : 817-334-1400
Fax Number : 817-334-1410
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2021
Last Update Date : 01/30/2026

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Directions to “ HOLLY KAREN MULLINS ” Practice Location

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