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General NPI Number Information
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NPI Number | 1477342673
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Entity Type | Organization
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Legal Business Name | MARK MULLINS NURSE PRACTITIONER CONTRACTING SERVICES LLC
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 1921 FRONT ST
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City | RICHLANDS
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State | VA
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Zip | 24641-2350
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Country | US
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Telephone | 469-915-4211
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Fax | 276-582-0509
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Provider Business Mailing Address
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Address Line | 1725 BAPTIST VALLEY RD
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City | CEDAR BLUFF
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State | VA
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Zip | 24609-8642
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Country | US
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Telephone | 469-915-4211
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Fax |
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Authorized Official
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Title or Position | CREDENTIALIST
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Name | AL BERRY
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Credential |
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Telephone | 469-915-4211
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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 |
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License Number State |
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