Provider Demographics
NPI:1265953350
Name:MULLANE, JEANETTE MARGARET (FNP-C)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:MARGARET
Last Name:MULLANE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4138 DURHAM LNDG
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-1006
Mailing Address - Country:US
Mailing Address - Phone:423-586-1717
Mailing Address - Fax:
Practice Address - Street 1:4138 DURHAM LNDG
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-1006
Practice Address - Country:US
Practice Address - Phone:423-586-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22735363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily