Provider Demographics
NPI:1982175337
Name:MULLINS, PAULA J (CRNP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:J
Last Name:MULLINS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 NILES CORTLAND RD NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-1977
Mailing Address - Country:US
Mailing Address - Phone:330-393-3376
Mailing Address - Fax:330-394-3376
Practice Address - Street 1:311 NILES CORTLAND RD NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1977
Practice Address - Country:US
Practice Address - Phone:330-393-3376
Practice Address - Fax:330-394-3376
Is Sole Proprietor?:No
Enumeration Date:2018-12-11
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR234804363L00000X
OHAPRN.CNP.025359363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner