Provider Demographics
NPI:1346301785
Name:MULLIN, CHRISTY JOY (FNP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:JOY
Last Name:MULLIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3790 HEDGESVILLE RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:HEDGESVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25427-6704
Mailing Address - Country:US
Mailing Address - Phone:304-754-7160
Mailing Address - Fax:304-754-7244
Practice Address - Street 1:3790 HEDGESVILLE ROAD
Practice Address - Street 2:SUITE H
Practice Address - City:HEDGESVILLE
Practice Address - State:WV
Practice Address - Zip Code:25427-6704
Practice Address - Country:US
Practice Address - Phone:304-754-7160
Practice Address - Fax:304-754-7244
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR157962363LF0000X
WV57766363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD211841Medicare PIN