Provider Demographics
NPI:1821733247
Name:MULLEN, SEAN PATIRICK (PMHNP)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:PATIRICK
Last Name:MULLEN
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3450 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2331
Mailing Address - Country:US
Mailing Address - Phone:602-351-6986
Mailing Address - Fax:602-266-9025
Practice Address - Street 1:7600 E FLORENTINE RD STE 101
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-1314
Practice Address - Country:US
Practice Address - Phone:026-351-6986
Practice Address - Fax:602-266-9025
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ220442363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health