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General NPI Number Information
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NPI Number | 1730334293
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Entity Type | Individual
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Provider Name | SHERRILY BROWN MULLENEAUX CFNP
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Gender | Female
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Dates
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Enumeration Date | 11/25/2008
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 404 W AERO DR
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City | PAYSON
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State | AZ
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Zip | 85541-5407
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Country | US
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Telephone | 602-351-6986
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 N 3RD ST
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City | PHOENIX
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State | AZ
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Zip | 85012-2331
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Country | US
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Telephone | 602-635-1069
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Fax | 602-266-9025
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP10417
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 344124-4405
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP2286
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License Number State | AZ
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