Individual
MARILYN MCNULTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5875 BREMO RD, SUITE G-5, RICHMOND, VA 23226-1934
(804) 287-7840
(804) 287-7845
Mailing address
5875 BREMO RD, SUITE G-5, RICHMOND, VA 23226-1934
(804) 287-7840
(804) 287-7845
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024171047
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTAN
VA
Enumeration date
08/07/2013
Last updated
08/07/2013
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