Individual
LAURA S MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9072 N 42ND ST, HICKORY CORNERS, MI 49060-9542
(269) 373-7488
(269) 373-0123
Mailing address
200 N PARK ST, KALAMAZOO, MI 49007-3731
(269) 373-7488
(269) 373-0123
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704084579
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548239767
—
MI
05
—
4332789
—
MI
01
—
7309236
AETNA
—
Enumeration date
03/17/2006
Last updated
11/22/2019
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