Provider Demographics
NPI:1164092144
Name:MULHERIN, MAGGIE ELLEN (CNP)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:ELLEN
Last Name:MULHERIN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6819 PORTER CENTRAL RD.
Mailing Address - Street 2:
Mailing Address - City:CENTERBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43011
Mailing Address - Country:US
Mailing Address - Phone:614-843-5150
Mailing Address - Fax:
Practice Address - Street 1:6819 PORTER CENTRAL RD.
Practice Address - Street 2:
Practice Address - City:CENTERBURG
Practice Address - State:OH
Practice Address - Zip Code:43011
Practice Address - Country:US
Practice Address - Phone:614-843-5150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0028639363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily