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General NPI Number Information
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NPI Number | 1366295859
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Entity Type | Individual
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Provider Name | KAITLYN MULLINS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 10121 HURLEY RD.
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City | HURLEY
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State | VA
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Zip | 24620
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Country | US
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Telephone | 276-528-2133
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Fax | 304-967-5336
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Provider Business Mailing Address
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Address Line | 10121 HURLEY RD
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City | HURLEY
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State | VA
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Zip | 24614
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Country | US
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Telephone | 276-528-2133
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4018316
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024189932
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 119019
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024189932
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License Number State | VA
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