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Individual

JENNIFER MULLICAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1301 SUMMER LEE DR, ROCKWALL, TX 75032-5452
(972) 771-8111
Mailing address
19212 LUEDTKE LN, PFLUGERVILLE, TX 78660-5022

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10951
TX

Other

Enumeration date
11/09/2016
Last updated
11/09/2016
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