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NPI Code Detail

MEDICARE: MRS. KATELYN NICOLE MULLINS CRNP

MEDICARE:  MRS. KATELYN NICOLE MULLINS  CRNP
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
1363LG0600XGerontology Nurse Practitioner1-164575AL
2163W00000XRegistered Nurse1-164575AL

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 : 1619597721
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATELYN NICOLE MULLINS CRNP
Provider Business Mailing Address
First Line : 1201 11TH AVE S
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35205-3423
Country : US
Telephone Number : 205-934-3441
Fax Number : 205-930-8378
Provider Business Practice Location Address
First Line : 1201 11TH AVE S
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35205-3423
Country : US
Telephone Number : 205-934-3411
Fax Number : 205-930-8378
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2020
Last Update Date : 03/12/2026

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Directions to “ MRS. KATELYN NICOLE MULLINS CRNP” Practice Location

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