Provider Demographics
NPI:1386670818
Name:MULA, NANCY (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:MULA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7020 HIGHWAY 190
Mailing Address - Street 2:SUITE C
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-4954
Mailing Address - Country:US
Mailing Address - Phone:985-871-7337
Mailing Address - Fax:985-871-7600
Practice Address - Street 1:7020 HIGHWAY 190
Practice Address - Street 2:SUITE C
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-4954
Practice Address - Country:US
Practice Address - Phone:985-871-7337
Practice Address - Fax:985-871-7600
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA018273208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1377848Medicaid
F75553Medicare UPIN