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NPI Code Detail

MEDICARE: MRS. JACQUELINE M MULA C.R.N.A

MEDICARE: MRS. JACQUELINE M MULA C.R.N.A
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
1367500000XCertified Registered Nurse Anesthetist128551MA

General Provider Information

NPI Number : 1164429023
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JACQUELINE M MULA C.R.N.A
Provider Business Mailing Address
First Line : 340 MAIN ST
Second Line : SUITE 670
City : WORCESTER
State : MA
Zip : 01608-1604
Country : US
Telephone Number : 508-754-3566
Fax Number : 508-798-8012
Provider Business Practice Location Address
First Line : 363 HIGHLAND AVE
Second Line :
City : FALL RIVER
State : MA
Zip : 02720-3703
Country : US
Telephone Number : 508-679-3131
Fax Number : 508-679-7146
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2005
Last Update Date : 04/10/2009

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