Provider Demographics
NPI:1669841904
Name:MC MULLEN, FELICIA RENEE (CPM, LDEM)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:RENEE
Last Name:MC MULLEN
Suffix:
Gender:F
Credentials:CPM, LDEM
Other - Prefix:
Other - First Name:TRUSTING
Other - Middle Name:HANDS
Other - Last Name:MIDWIFERY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPM, LDEM
Mailing Address - Street 1:3235 CHESTER GROVE RD
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2474
Mailing Address - Country:US
Mailing Address - Phone:240-810-2254
Mailing Address - Fax:240-366-8036
Practice Address - Street 1:3235 CHESTER GROVE RD UPPR MARLBORO
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-2474
Practice Address - Country:US
Practice Address - Phone:240-229-4662
Practice Address - Fax:240-244-3361
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0129000180176B00000X
MDDEM00038176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife