Individual
MS. KELLY VERONICA MULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
121 PULASKI RD, KINGS PARK, NY 11754-2539
(631) 678-8470
Mailing address
39 SOUNDVIEW DR, NORTHPORT, NY 11768-1446
(631) 678-8470
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
F306187
NY
363LP2300X
Primary Care Nurse Practitioner
Primary
306187
NY
Other
Enumeration date
04/07/2016
Last updated
12/19/2024
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