Individual
MRS. ALLY SHAE MULLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
110 HAMPTON PL, MADISON, MS 39110-4575
(352) 672-5175
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00884
MS
Other
Enumeration date
06/29/2024
Last updated
03/10/2025
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