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NPI Code Detail

MEDICARE: JAMES ELI MULLINS IV FNP

MEDICARE:   JAMES ELI MULLINS IV FNP
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
1363LF0000XFamily Nurse Practitioner23655TN

General Provider Information

NPI Number : 1588147078
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES ELI MULLINS IV FNP
Provider Business Mailing Address
First Line : 2620 ELM HILL PIKE
Second Line :
City : NASHVILLE
State : TN
Zip : 37214-3108
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9025 HIGHWAY 64
Second Line :
City : LAKELAND
State : TN
Zip : 38002-8448
Country : US
Telephone Number : 901-387-2998
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2018
Last Update Date : 10/30/2023

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