Healthcare Provider Details

I. General information

NPI: 1639552896
Provider Name (Legal Business Name): ANN MULLINS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 E MAIN ST
CLINTON CT
06413-2131
US

IV. Provider business mailing address

120 CONNECTICUT AVE
NORWALK CT
06854-1525
US

V. Phone/Fax

Practice location:
  • Phone: 860-664-0787
  • Fax: 860-664-1982
Mailing address:
  • Phone: 203-899-1770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20035
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number073181-23
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6719
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: