MEDICARE: AMANDA MULLINS RN, MSN, CNP, LLC

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
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1811551278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMANDA MULLINS RN, MSN, CNP, LLC

Provider Business Mailing Address
First Line	:	6823 BRAMBLE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-3211
Country	:	US
Telephone Number	:	513-368-4126
Fax Number	:	513-440-1980

Provider Business Practice Location Address
First Line	:	6823 BRAMBLE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-3211
Country	:	US
Telephone Number	:	513-368-4126
Fax Number	:	513-440-1980

Authorized Official
Title or Position	:	BILLER
Name	:	DEONNA FIELDS
Credential	:	CPC
Telephone Number	:	304-767-8919

Provider Enumeration Date	:	04/30/2019
Last Update Date	:	12/09/2025

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