Individual
KATHY ANN MULLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
333 E COUNTY LINE RD, SUITE B, GREENWOOD, IN 46143-1080
(317) 621-1247
(317) 497-6334
Mailing address
6626 E. 75TH STREET, SUITE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71002837A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200941670
—
IN
01
—
P01157059
RR MEDICARE PTAN
IN
Enumeration date
02/16/2009
Last updated
11/27/2023
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