Provider Demographics
NPI:1982723268
Name:MULVEY, SUE ANN (RN)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:ANN
Last Name:MULVEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 FORKER BLVD
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-3646
Mailing Address - Country:US
Mailing Address - Phone:724-981-4885
Mailing Address - Fax:724-981-9444
Practice Address - Street 1:87 STAMBAUGH AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-2775
Practice Address - Country:US
Practice Address - Phone:724-981-1671
Practice Address - Fax:724-981-9444
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN505516L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN505516LOtherREGISTERED NURSE