Individual
MRS. SHYLA MARI MULLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
183 PARK AVE, SHARON, WI 53585-9628
(262) 607-3033
Mailing address
183, SHARON, WISCONSIN 53585
(262) 607-3033
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
315673-31
WI
Other
Enumeration date
04/19/2012
Last updated
04/19/2012
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