Provider Demographics
NPI:1194512434
Name:MULLINS, HALEY E
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:E
Last Name:MULLINS
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 1:5555 S BOATMAN RD
Mailing Address - Street 2:
Mailing Address - City:UNDERWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:47177-6810
Mailing Address - Country:US
Mailing Address - Phone:812-722-3839
Mailing Address - Fax:
Practice Address - Street 1:911 N SHELBY ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:IN
Practice Address - Zip Code:47167-2304
Practice Address - Country:US
Practice Address - Phone:812-883-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist