Individual
MAGEN MULLINIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
346 CENTRAL AVE, BOWLING GREEN, KY 42101-7512
(270) 222-3851
(833) 673-0436
Mailing address
881 GOSHEN RD, ALVATON, KY 42122-9654
(615) 388-8469
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1118
TN
363A00000X
Physician Assistant
Primary
PA1117
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508213
—
TN
Enumeration date
03/15/2007
Last updated
03/07/2023
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