Healthcare Provider Details

I. General information

NPI: 1598226045
Provider Name (Legal Business Name): JOSHUA ADAM MULLINS FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 VALLEY ST NE
ABINGDON VA
24210-2912
US

IV. Provider business mailing address

300 VALLEY ST NE
ABINGDON VA
24210-2912
US

V. Phone/Fax

Practice location:
  • Phone: 276-206-8197
  • Fax:
Mailing address:
  • Phone: 276-206-8197
  • Fax: 276-206-8761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number0024177387
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number0024177387
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024177387
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3013320
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: