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Individual

MICHELLE MULLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
2220 LEMP AVE, SAINT LOUIS, MO 63104-2700
(314) 898-1700
(314) 814-8542
Mailing address
PO BOX 551, SAINT LOUIS, MO 63188-0551
(314) 898-1700
(314) 814-8542

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2016010736
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2016010736
LICENSE
MO
Enumeration date
04/22/2016
Last updated
10/31/2018
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