Healthcare Provider Details

I. General information

NPI: 1669643623
Provider Name (Legal Business Name): NONIE ILONA MULLER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 VINE ST PRIMARY CARE/MENTAL HEALTH INTEGRATION
CINCINNATI OH
45220-2213
US

IV. Provider business mailing address

3200 VINE ST PRIMARY CARE/MENTAL HEALTH INTEGRATION
CINCINNATI OH
45220
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-6304
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN112720
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: