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General NPI Number Information
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NPI Number | 1962792168
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Entity Type | Individual
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Provider Name | DEBORAH MULLINS
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Gender | Female
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Dates
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Enumeration Date | 04/10/2011
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Last Update Date | 04/10/2011
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Provider Practice Location Address
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Address Line | 59 HIGHWAY 15 N
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City | JACKSON
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State | KY
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Zip | 41339-9631
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Country | US
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Telephone | 606-666-2883
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Fax | 606-666-5281
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Provider Business Mailing Address
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Address Line | 4603 KY 1094
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City | CAMPTON
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State | KY
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Zip | 41301-8581
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Country | US
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Telephone | 606-662-4245
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Fax | 606-662-4245
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 11075
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License Number State | KY
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