Provider Demographics
NPI:1265279939
Name:MULLINS, HOLLY LYNN (FNP)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:LYNN
Last Name:MULLINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 COUNTRY KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-6111
Mailing Address - Country:US
Mailing Address - Phone:607-237-9235
Mailing Address - Fax:
Practice Address - Street 1:333 HOOPER RD
Practice Address - Street 2:
Practice Address - City:ENDWELL
Practice Address - State:NY
Practice Address - Zip Code:13760-3641
Practice Address - Country:US
Practice Address - Phone:607-583-0521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY354366363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily