Individual
MR. CHARLES NEWTON MULLICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
400 S KINGSHIGHWAY BLVD, DEPT EMERGENCY MED, SAINT LOUIS, MO 63110-1014
(314) 362-9123
(314) 747-3338
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-9123
(314) 747-3338
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2010010952
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
424152601
—
MO
Enumeration date
01/18/2010
Last updated
04/17/2025
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