Provider Demographics
NPI:1932878535
Name:MULLINS, LINDA SUE (FNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:SUE
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 1:208 FRONT ST W
Mailing Address - Street 2:
Mailing Address - City:COEBURN
Mailing Address - State:VA
Mailing Address - Zip Code:24230-7019
Mailing Address - Country:US
Mailing Address - Phone:276-777-0380
Mailing Address - Fax:
Practice Address - Street 1:208 FRONT ST W
Practice Address - Street 2:
Practice Address - City:COEBURN
Practice Address - State:VA
Practice Address - Zip Code:24230-2423
Practice Address - Country:US
Practice Address - Phone:276-777-0380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001210640163W00000X
TN30544363LF0000X
VA0024182647363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse