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NPI Code Detail

MEDICARE: KANI MICHELE MULLINS FNP-C

MEDICARE: KANI MICHELE MULLINS FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner5009391NC

General Provider Information

NPI Number : 1073047379
Entity Type Code : Individual
Provider Name (Legal Business Name) : KANI MICHELE MULLINS FNP-C
Provider Business Mailing Address
First Line : PO BOX 744786
Second Line :
City : ATLANTA
State : GA
Zip : 30374-4786
Country : US
Telephone Number : 704-834-2450
Fax Number : 704-671-5331
Provider Business Practice Location Address
First Line : 4235 S NEW HOPE RD STE A
Second Line :
City : GASTONIA
State : NC
Zip : 28056-8453
Country : US
Telephone Number : 704-825-4750
Fax Number : 704-825-6985
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2017
Last Update Date : 02/16/2022

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Directions to “ KANI MICHELE MULLINS FNP-C” Practice Location

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