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NPI Code Detail

MEDICARE: MS. ANGELA D MULLINS A.P.R.N.

MEDICARE: MS. ANGELA D MULLINS A.P.R.N.
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 Practitioner3004001KY
2363LF0000XFamily Nurse Practitioner3004001KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000360625OTHERKYANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578568390
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANGELA D MULLINS A.P.R.N.
Provider Business Mailing Address
First Line : PO BOX 21890
Second Line :
City : BELFAST
State : ME
Zip : 04915-4115
Country : US
Telephone Number : 502-907-0356
Fax Number : 502-919-9780
Provider Business Practice Location Address
First Line : 120 EXECUTIVE PARK
Second Line :
City : LOUISVILLE
State : KY
Zip : 40207-4201
Country : US
Telephone Number : 502-855-7200
Fax Number : 502-855-7201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 02/20/2024

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