Provider Demographics
NPI:1467144543
Name:MULLER, MAG CATHRINE
Entity Type:Individual
Prefix:
First Name:MAG
Middle Name:CATHRINE
Last Name:MULLER
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 1:140 SACHEM ST
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-4265
Mailing Address - Country:US
Mailing Address - Phone:602-312-5924
Mailing Address - Fax:
Practice Address - Street 1:140 SACHEM ST
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-4265
Practice Address - Country:US
Practice Address - Phone:602-312-5924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1008651164W00000X
FL5233765164W00000X
RI11739164W00000X
CA688963164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse