Provider Demographics
NPI:1376987719
Name:MULLENAX, JULIA A (APN)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:A
Last Name:MULLENAX
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:MULLENAX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APN
Mailing Address - Street 1:4301 W MARKHAM ST # 748
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-526-6860
Mailing Address - Fax:501-686-5212
Practice Address - Street 1:4301 W MARKHAM ST # 748
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-526-6860
Practice Address - Fax:501-686-5212
Is Sole Proprietor?:No
Enumeration Date:2013-04-27
Last Update Date:2013-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003819364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology