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NPI Code Detail

MEDICARE: SCHANNON MULLEN RN

MEDICARE: SCHANNON MULLEN RN
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 PractitionerNURS-RN-LIC-132267MT

General Provider Information

NPI Number : 1710796644
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCHANNON MULLEN RN
Provider Business Mailing Address
First Line : 1101 26TH ST S
Second Line :
City : GREAT FALLS
State : MT
Zip : 59405-5161
Country : US
Telephone Number : 406-455-5000
Fax Number :
Provider Business Practice Location Address
First Line : 1101 26TH ST S
Second Line :
City : GREAT FALLS
State : MT
Zip : 59405-5161
Country : US
Telephone Number : 406-455-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2025
Last Update Date : 06/15/2026

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