Healthcare Provider Details

I. General information

NPI: 1720999659
Provider Name (Legal Business Name): ANASTASIA MULINIX NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 SOUTHFIELD DR
PLAINFIELD IN
46168-2955
US

IV. Provider business mailing address

4530 YOLANDER LN
AVON IN
46123-8070
US

V. Phone/Fax

Practice location:
  • Phone: 317-406-8600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number71018415A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: