Individual
GENNIE MARIE MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-C
Contact information
Practice address
1501 W 7TH ST STE 2, CHANUTE, KS 66720-2516
(620) 243-2558
(620) 431-1192
Mailing address
PO BOX 426, CHANUTE, KS 66720-0426
(620) 244-5105
(620) 244-5111
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
78874
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
78874
KS APRN LICENSE
KS
Enumeration date
07/12/2019
Last updated
09/01/2021
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