Provider Demographics
NPI:1104222496
Name:MULHOLLAND, LESYA (RN)
Entity Type:Individual
Prefix:
First Name:LESYA
Middle Name:
Last Name:MULHOLLAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5765 S HARLAN ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-0874
Mailing Address - Country:US
Mailing Address - Phone:303-319-4967
Mailing Address - Fax:
Practice Address - Street 1:5765 S HARLAN ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-0874
Practice Address - Country:US
Practice Address - Phone:303-319-4967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1627331163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse