Provider Demographics
NPI:1114435872
Name:SHERO HOUSECALLS LLC
Entity Type:Organization
Organization Name:SHERO HOUSECALLS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:SOPHIA
Authorized Official - Last Name:MULLINER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:856-325-9301
Mailing Address - Street 1:226 DICKENS CT
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2837
Mailing Address - Country:US
Mailing Address - Phone:856-325-9301
Mailing Address - Fax:
Practice Address - Street 1:226 DICKENS CT
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2837
Practice Address - Country:US
Practice Address - Phone:856-325-9301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1578729943363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1609207737OtherUNKNOWN