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NPI Code Detail

MEDICARE: LORA MULLINS BSW

MEDICARE: LORA MULLINS BSW
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
11041C0700XClinical Social WorkerKY

General Provider Information

NPI Number : 1538598875
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORA MULLINS BSW
Provider Business Mailing Address
First Line : 2250 THUNDERSTICK DRIVE
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-4266
Country : US
Telephone Number : 859-254-1035
Fax Number : 859-254-2075
Provider Business Practice Location Address
First Line : 2250 THUNDERSTICK DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40505-9010
Country : US
Telephone Number : 859-254-1035
Fax Number : 859-254-2075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2013
Last Update Date : 07/21/2022

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