Individual
DR. ELLEN SHEA MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2312 E MAIN ST, SUITE B, NEW IBERIA, LA 70560-4064
(337) 364-0938
(337) 359-9024
Mailing address
2308 E MAIN ST, SUITE A, NEW IBERIA, LA 70560-4041
(337) 364-8566
(337) 359-9024
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
021129
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021129
STATE LICENSE
LA
05
—
1466352
—
LA
Enumeration date
08/15/2005
Last updated
02/25/2013
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