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NPI Code Detail

MEDICARE: STACEY SATCHWELL MULLIN ARNP, CNM

MEDICARE: STACEY SATCHWELL MULLIN ARNP, CNM
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
1363LX0001XObstetrics & Gynecology Nurse PractitionerAPRN.CNM.0019493OH
2367A00000XAdvanced Practice Midwife3005980KY
3367A00000XAdvanced Practice MidwifeAPRN.CNM.0019493OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497992333
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY SATCHWELL MULLIN ARNP, CNM
Provider Business Mailing Address
First Line : 215 E 11TH ST
Second Line :
City : NEWPORT
State : KY
Zip : 41071-2203
Country : US
Telephone Number : 859-655-6100
Fax Number :
Provider Business Practice Location Address
First Line : 3590 LUCILLE DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45213-2674
Country : US
Telephone Number : 513-475-8588
Fax Number : 513-475-8598
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2009
Last Update Date : 12/27/2021

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