Healthcare Provider Details

I. General information

NPI: 1417899469
Provider Name (Legal Business Name): ABBEY LEANN MULLINS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17733 HIGHWAY 50 W
CEDARBLUFF MS
39741-0402
US

IV. Provider business mailing address

17733 HIGHWAY 50 W
CEDARBLUFF MS
39741-0402
US

V. Phone/Fax

Practice location:
  • Phone: 662-295-7216
  • Fax:
Mailing address:
  • Phone: 662-295-7216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number908335
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: