Provider Demographics
NPI:1598912214
Name:MULLIN, DONNA MARIE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MARIE
Last Name:MULLIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11670 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3021
Mailing Address - Country:US
Mailing Address - Phone:561-691-8655
Mailing Address - Fax:561-691-8656
Practice Address - Street 1:11670 U.S. HWY ONE
Practice Address - Street 2:
Practice Address - City:PALM BAECH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33408-1612
Practice Address - Country:US
Practice Address - Phone:561-691-8655
Practice Address - Fax:561-691-8656
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2120742363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE8526OtherMEDICARE PROVIDER NUMBER
FLP75943Medicare UPIN