=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316801368
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DENISE MICHELE MULLINS DNP, RN,COHN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/15/2025
-----------------------------------------------------
Last Update Date | 12/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4170 NORMAN SCOTT RD STE 5
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92136-5521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-404-9614
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 35948 AVIGNON CT
-----------------------------------------------------
City | WINCHESTER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92596-9168
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-404-9614
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WG0000X
-----------------------------------------------------
Taxonomy Name | General Practice Registered Nurse
-----------------------------------------------------
License Number | RN3389752
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163WX0106X
-----------------------------------------------------
Taxonomy Name | Occupational Health Registered Nurse
-----------------------------------------------------
License Number | RN95416235
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------