Provider Demographics
NPI:1396535159
Name:MULLINS, KIANA LASHAY (LPN)
Entity type:Individual
Prefix:
First Name:KIANA
Middle Name:LASHAY
Last Name:MULLINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5616 BIRCHDALE DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-1906
Mailing Address - Country:US
Mailing Address - Phone:419-213-0957
Mailing Address - Fax:
Practice Address - Street 1:5616 BIRCHDALE DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-1906
Practice Address - Country:US
Practice Address - Phone:419-213-0957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
OH184206164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies