Provider Demographics
NPI:1982924049
Name:MULCHAN, NEISHA T (APRNFNP-BC)
Entity Type:Individual
Prefix:MS
First Name:NEISHA
Middle Name:T
Last Name:MULCHAN
Suffix:
Gender:F
Credentials:APRNFNP-BC
Other - Prefix:
Other - First Name:NEISHA
Other - Middle Name:
Other - Last Name:MULCHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN FNP-C
Mailing Address - Street 1:8530 FIRESTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8530 FIRESTONE BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4926
Practice Address - Country:US
Practice Address - Phone:562-867-7999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017993363LF0000X
FLARNP9222221363LF0000X
FLAPRN9222221207QA0505X, 207Q00000X
FL9222221363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9222221OtherARNP
FLRN9222221OtherREGISTERED NURSE