Individual
JEAN HANNON MULLINS-PADGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(971) 285-6254
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
201909371NP-PP
OR
Other
Enumeration date
10/22/2019
Last updated
03/22/2021
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