Healthcare Provider Details

I. General information

NPI: 1548278344
Provider Name (Legal Business Name): LAURA P MULLEN APRN,BC (CNS)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 AKRON GENERAL AVE 4TH FLOOR - ACC
AKRON OH
44307-2432
US

IV. Provider business mailing address

1 AKRON GENERAL AVE 4TH FLOOR - ACC
AKRON OH
44307-2432
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-6525
  • Fax: 330-996-2943
Mailing address:
  • Phone: 330-344-6525
  • Fax: 330-996-2943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberNS-04447
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: