Individual
MRS. LENEA RAE MULLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP NURSE PRACTITIONE
Contact information
Practice address
3549 LAKESHORE DR, WATERFORD, MI 48329-2282
(248) 469-6093
Mailing address
3549 LAKESHORE DR, WATERFORD, MI 48329-2282
(248) 469-6093
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704230460
MI
363LA2200X
Adult Health Nurse Practitioner
4704230460
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
4704230460
MI
363LP2300X
Primary Care Nurse Practitioner
4704230460
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163W00000X
TAXONOMY
—
Enumeration date
04/05/2018
Last updated
02/01/2023
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