# SUSAN MCMULLEN

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

## Provider details

- **NPI number:** 1932160447
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | NP715A | ID | Yes |

## Other

- **Enumeration date:** 04/01/2006
- **Last updated:** 07/13/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000010152154 | BLUE SHIELD | ID |
| 01 | — | NPXB9 | BLUE CROSS | ID |