Individual
JACOB MULLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
12502 WILLOWBROOK RD, CUMBERLAND, MD 21502-6491
(240) 964-8944
(240) 964-8942
Mailing address
PO BOX 1671, CUMBERLAND, MD 21501-1671
(240) 964-8337
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R213462
MD
363LF0000X
Family Nurse Practitioner
R213462
MD
Other
Enumeration date
03/19/2021
Last updated
07/19/2021
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