Provider Demographics
NPI:1255207395
Name:MULLINS, MARY KRYSTA (CRNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KRYSTA
Last Name:MULLINS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 DEERS HEAD HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-3201
Mailing Address - Country:US
Mailing Address - Phone:410-572-6166
Mailing Address - Fax:
Practice Address - Street 1:351 DEERS HEAD HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-3201
Practice Address - Country:US
Practice Address - Phone:410-572-6166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR216532207QA0505X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine