Individual
CONNIE MULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
7950 S MILITARY TRL, 201, LAKE WORTH, FL 33463-8162
(561) 330-0993
(561) 594-1807
Mailing address
612 NW 15TH AVE, BOCA RATON, FL 33486-3238
(561) 330-0993
(561) 594-1807
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
MW45
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340011500
—
FL
Enumeration date
06/13/2005
Last updated
06/06/2013
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