Provider Demographics
NPI:1609207737
Name:MULLINER, PAULA S (CRNP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:S
Last Name:MULLINER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:
Other - Last Name:MULLINER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:51 NORTH 39TH ST.
Mailing Address - Street 2:4 PHI BLDG
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-662-9018
Mailing Address - Fax:
Practice Address - Street 1:51 NORTH 39TH ST.
Practice Address - Street 2:4 PHI BLDG
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-9018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013362363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health