Provider Demographics
NPI:1154665313
Name:MULLIS, RACHAEL ERIN (NP)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:ERIN
Last Name:MULLIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:777 FRANKLIN GATEWAY
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-7803
Mailing Address - Country:US
Mailing Address - Phone:770-732-6007
Mailing Address - Fax:770-732-8242
Practice Address - Street 1:777 FRANKLIN GATEWAY
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-7803
Practice Address - Country:US
Practice Address - Phone:770-732-6007
Practice Address - Fax:770-732-8242
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2023-05-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3007625363LP0200X
GA20121834363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics