Provider Demographics
NPI:1952333643
Name:MULLEN, PAMELA (RN, MSN, CNS)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:MULLEN
Suffix:
Gender:F
Credentials:RN, MSN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2059 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2633
Mailing Address - Country:US
Mailing Address - Phone:513-458-5646
Mailing Address - Fax:513-793-1032
Practice Address - Street 1:2059 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:OH
Practice Address - Zip Code:45212-2633
Practice Address - Country:US
Practice Address - Phone:513-458-4600
Practice Address - Fax:513-458-4604
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-202867163W00000X
OHNS-03201364SP0809X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse