Healthcare Provider Details

I. General information

NPI: 1811551278
Provider Name (Legal Business Name): AMANDA MULLINS RN, MSN, CNP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6823 BRAMBLE AVE
CINCINNATI OH
45227-3211
US

IV. Provider business mailing address

6823 BRAMBLE AVE
CINCINNATI OH
45227-3211
US

V. Phone/Fax

Practice location:
  • Phone: 513-368-4126
  • Fax: 513-440-1980
Mailing address:
  • Phone: 513-368-4126
  • Fax: 513-440-1980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DEONNA FIELDS
Title or Position: BILLER
Credential: CPC
Phone: 304-767-8919