Provider Demographics
NPI:1467031039
Name:MULLINS, RACHEL LELAND
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LELAND
Last Name:MULLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10813 STATE HIGHWAY 773
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:KY
Mailing Address - Zip Code:41132-8903
Mailing Address - Country:US
Mailing Address - Phone:606-371-9421
Mailing Address - Fax:
Practice Address - Street 1:4329 HUGHES BRANCH RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-9768
Practice Address - Country:US
Practice Address - Phone:304-733-1094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1162811163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse