Provider Demographics
NPI:1134826571
Name:MULLINIX, EMILY JOANNA (APRN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JOANNA
Last Name:MULLINIX
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:JOANNA
Other - Last Name:NUGENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:506 PATHFINDER
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76233-1522
Mailing Address - Country:US
Mailing Address - Phone:877-522-1275
Mailing Address - Fax:
Practice Address - Street 1:625 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-6229
Practice Address - Country:US
Practice Address - Phone:870-723-9949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR223459363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily