Individual
CAROL MULLICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
904 S 10TH ST, SAINT JOSEPH, MO 64503-2405
(816) 233-5188
Mailing address
904 S 10TH ST, SAINT JOSEPH, MO 64503-2405
(816) 233-5188
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
087609
MO
Other
Enumeration date
05/25/2007
Last updated
07/09/2007
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