# DR. JENNIFER LEIGH MULLENDORE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1417991845
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 200600657 | NC | Yes |
| 208D00000X | General Practice Physician | 2006-00657 | NC | — |

## Other

- **Enumeration date:** 06/15/2006
- **Last updated:** 07/12/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 190513 | MEDCOST | NC |
| 05 | — | 5904408 | — | NC |