Provider Demographics
NPI:1386034221
Name:MULHOLLAND, WILLIAM A (CNP)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:MULHOLLAND
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 S. NAPOLEON RD.
Mailing Address - Street 2:
Mailing Address - City:HARROD
Mailing Address - State:OH
Mailing Address - Zip Code:45850
Mailing Address - Country:US
Mailing Address - Phone:419-234-7316
Mailing Address - Fax:
Practice Address - Street 1:4240 SUN N LAKE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-1944
Practice Address - Country:US
Practice Address - Phone:863-471-3926
Practice Address - Fax:863-385-3093
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-30
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013402363LF0000X
OHNP16958363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNP16958OtherOHIO LICENSE