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NPI Code Detail

MEDICARE: AVA MCMULLEN

MEDICARE: AVA MCMULLEN
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1568355733
Entity Type Code : Individual
Provider Name (Legal Business Name) : AVA MCMULLEN
Provider Business Mailing Address
First Line : 1695 MARY LOU RETTON DR
Second Line :
City : FAIRMONT
State : WV
Zip : 26554-2062
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1695 MARY LOU RETTON DR
Second Line :
City : FAIRMONT
State : WV
Zip : 26554-2062
Country : US
Telephone Number : 304-281-1896
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2025
Last Update Date : 05/29/2025

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Directions to “ AVA MCMULLEN ” Practice Location

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