Provider Demographics
NPI:1881675361
Name:MULLER, M. ANNIE (DNP, FNP/APRN)
Entity type:Individual
Prefix:
First Name:M.
Middle Name:ANNIE
Last Name:MULLER
Suffix:
Gender:F
Credentials:DNP, FNP/APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-777-6870
Mailing Address - Fax:843-777-6871
Practice Address - Street 1:3015 W PALMETTO ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5935
Practice Address - Country:US
Practice Address - Phone:843-777-6870
Practice Address - Fax:843-777-6871
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2583363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC226111OtherMEDCOST
SCNP1556Medicaid
SC20-2935692-062OtherBCBS
SCAA47218552OtherMEDICARE PTAN
SC20-2935692-063OtherBCBS