Individual
AMBER SUE MULALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-4300
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-4300
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024172373
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024172373
LICENSE
VA
Enumeration date
03/27/2015
Last updated
05/27/2020
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