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Individual

SAMANTHA MULLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NNP

Contact information

Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 382-4321
(541) 706-7068
Mailing address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-4109

Taxonomy

Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
5011980
NC
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
5011980
NC

Other

Enumeration date
07/11/2019
Last updated
04/01/2024
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