Provider Demographics
NPI:1326215104
Name:MULLANE, NANCY LOUISE (MED, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LOUISE
Last Name:MULLANE
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 MAGNOLIA FOREST CT
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-4531
Mailing Address - Country:US
Mailing Address - Phone:919-271-7462
Mailing Address - Fax:
Practice Address - Street 1:720 MAGNOLIA FOREST CT
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-4531
Practice Address - Country:US
Practice Address - Phone:919-271-7462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7679235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist