Provider Demographics
NPI:1235605379
Name:MULHOLLAND, LINDSEY LEE
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:LEE
Last Name:MULHOLLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:LEE
Other - Last Name:MANGUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:95 MILL RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:GODWIN
Mailing Address - State:NC
Mailing Address - Zip Code:28344-5100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1327 ROBESON ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5531
Practice Address - Country:US
Practice Address - Phone:910-486-5437
Practice Address - Fax:910-486-0011
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC77675174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN