Provider Demographics
NPI:1558315952
Name:MULLON, DARLENE K (MD)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:K
Last Name:MULLON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 6210
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87499-6210
Mailing Address - Country:US
Mailing Address - Phone:505-609-2258
Mailing Address - Fax:505-609-2259
Practice Address - Street 1:7751 W FLAMINGO RD
Practice Address - Street 2:SUITE A-100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-5401
Practice Address - Country:US
Practice Address - Phone:702-804-6555
Practice Address - Fax:702-804-1998
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2018-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV114092084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVF26906Medicare UPIN