Healthcare Provider Details

I. General information

NPI: 1134291321
Provider Name (Legal Business Name): NANCY B MULLINS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY LOCKHART HILL FNP

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 E UNIVERSITY DR
MESA AZ
85201-5932
US

IV. Provider business mailing address

202 E EARLL DR SUITE 200
PHOENIX AZ
85012-2634
US

V. Phone/Fax

Practice location:
  • Phone: 602-808-2800
  • Fax: 602-808-2799
Mailing address:
  • Phone: 602-808-2800
  • Fax: 602-808-2799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP1485
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: