Provider Demographics
NPI:1093437238
Name:MULHOLLAND, GINGER ANN
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:ANN
Last Name:MULHOLLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 COLUMBIA ROAD 76
Mailing Address - Street 2:
Mailing Address - City:WALDO
Mailing Address - State:AR
Mailing Address - Zip Code:71770-9042
Mailing Address - Country:US
Mailing Address - Phone:870-949-2807
Mailing Address - Fax:
Practice Address - Street 1:1920 SOUTH WASHINGTON
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753
Practice Address - Country:US
Practice Address - Phone:870-949-2807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR221018363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care