Provider Demographics
NPI:1558584193
Name:MULLENS, HEATHER M (DO)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:M
Last Name:MULLENS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 W WILLIAMS ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-3955
Mailing Address - Country:US
Mailing Address - Phone:919-363-0190
Mailing Address - Fax:
Practice Address - Street 1:1031 W WILLIAMS ST
Practice Address - Street 2:SUITE 106
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-3955
Practice Address - Country:US
Practice Address - Phone:919-363-0190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00156207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine