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EVANGELISTA M MULLINAX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
200 HAWTHORNE LANE, CHARLOTTE, NC 28204
(704) 384-4239
(704) 384-5636
Mailing address
PO BOX 601549, CHARLOTTE, NC 28260-1549
(704) 384-4239
(704) 384-5636

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
68743
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8050829
NC
05
NAN092
SC
Enumeration date
05/04/2006
Last updated
07/06/2017
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