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General NPI Number Information
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NPI Number | 1376152553
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Entity Type | Individual
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Provider Name | AMY HOUSTON MULLIS CRNP
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Gender | Female
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Dates
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Enumeration Date | 07/23/2020
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 600 OFFICE CENTER DR BLDG 600
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City | FORT WASHINGTON
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State | PA
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Zip | 19034-3293
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Country | US
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Telephone | 717-316-2163
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Fax | 570-271-6578
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Provider Business Mailing Address
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Address Line | 166 SEMINARY AVE
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City | GETTYSBURG
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State | PA
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Zip | 17325-1721
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Country | US
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Telephone | 717-253-8535
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | SP022250
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | SP022250
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License Number State | PA
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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 | SP022250
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License Number State | PA
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