Provider Demographics
NPI:1104042571
Name:MULLENIX, SHERRY THOMAS (JD, RN)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:THOMAS
Last Name:MULLENIX
Suffix:
Gender:F
Credentials:JD, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:PO BOX 847
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-0847
Mailing Address - Country:US
Mailing Address - Phone:205-631-1201
Mailing Address - Fax:205-608-1596
Practice Address - Street 1:2660 MOUNT OLIVE RD
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVE
Practice Address - State:AL
Practice Address - Zip Code:35117-3925
Practice Address - Country:US
Practice Address - Phone:205-631-1201
Practice Address - Fax:205-608-1596
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL34337163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse