Provider Demographics
NPI:1629774831
Name:MULDROW, CONSTANCE D
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:D
Last Name:MULDROW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 OUTLOOK AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1847
Mailing Address - Country:US
Mailing Address - Phone:330-956-0204
Mailing Address - Fax:
Practice Address - Street 1:2732 RUSH BLVD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44507-1563
Practice Address - Country:US
Practice Address - Phone:330-956-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion