Individual
SUSAN A MULLENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
621 S ILLINOIS AVE, SUITE 100, MASON CITY, IA 50401-5489
(641) 422-6900
(641) 422-6909
Mailing address
621 S ILLINOIS AVE, SUITE 103, MASON CITY, IA 50401-5489
(641) 494-3041
(641) 494-3059
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
045579
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0428599
—
IA
01
—
06909
WELLMARK
IA
Enumeration date
08/31/2006
Last updated
07/08/2007
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