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Individual

ATHENA JMULLINS MULLINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-AA

Contact information

Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(866) 507-5244
(855) 851-4405
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
003008
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003008
GA LICENSE NUMBER
GA
Enumeration date
08/21/2006
Last updated
11/18/2014
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