Individual
JENNY FAYE MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
279 E MAIN ST, HAZARD, KY 41701-1973
(606) 487-9505
(606) 436-0071
Mailing address
279 E MAIN ST, HAZARD, KY 41701-1973
(606) 487-9505
(606) 436-0071
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03746
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
181848
FQHC LEE COUNTY
KY
01
—
181853
FQHC BREATHITT
KY
05
—
7100323170
—
KY
Enumeration date
08/17/2011
Last updated
08/17/2021
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