Provider Demographics
NPI:1518143619
Name:MULLIS, NANCY ELLEN (ND)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ELLEN
Last Name:MULLIS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 W CAMELBACK RD
Mailing Address - Street 2:SUITE1500
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-3466
Mailing Address - Country:US
Mailing Address - Phone:602-510-9346
Mailing Address - Fax:602-864-2949
Practice Address - Street 1:2001 W CAMELBACK RD
Practice Address - Street 2:SUITE1500
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-3466
Practice Address - Country:US
Practice Address - Phone:602-510-9346
Practice Address - Fax:602-864-2949
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ00586175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath