Provider Demographics
NPI:1134291321
Name:MULLINS, NANCY B (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:B
Last Name:MULLINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:LOCKHART HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:202 E EARLL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2634
Mailing Address - Country:US
Mailing Address - Phone:602-808-2800
Mailing Address - Fax:602-808-2799
Practice Address - Street 1:262 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-5932
Practice Address - Country:US
Practice Address - Phone:602-808-2800
Practice Address - Fax:602-808-2799
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1485363LF0000X
AZRN059547363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ836976Medicaid
AZZ182571OtherMEDICARE PTAN