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General NPI Number Information
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NPI Number | 1407895667
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Entity Type | Individual
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Provider Name | SUSAN CAROL MCMULLEN N.P.02/07/1966
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Gender | Female
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 10121 PINE AVE EXTENDED CARE SNF
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City | TRUCKEE
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State | CA
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Zip | 96161-4856
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Country | US
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Telephone | 530-582-3251
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Fax | 530-582-3281
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Provider Business Mailing Address
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Address Line | 10956 DONNER PASS RD #230
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City | TRUCKEE
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State | CA
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Zip | 96161-4861
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Country | US
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Telephone | 530-582-3277
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Fax | 530-550-0544
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11292
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License Number State | CA
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