Provider Demographics
NPI:1417132101
Name:MULLIN, RUBY ZUIE LAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:RUBY
Middle Name:ZUIE LAN
Last Name:MULLIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:LEW
Other - Middle Name:ZUIE LAN
Other - Last Name:MULLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5960 12TH ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-5027
Mailing Address - Country:US
Mailing Address - Phone:727-866-7963
Mailing Address - Fax:
Practice Address - Street 1:5960 12TH ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-5027
Practice Address - Country:US
Practice Address - Phone:727-866-7963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-01
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6905671177F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging