Individual
KIMBERLY RENAE MULLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
121 ADVANCED TECHNOLOGY DRIVE, DUFFIELD, VA 24244
(276) 431-2648
(276) 431-2082
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
(423) 857-2070
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0017140919
VA
164W00000X
Licensed Practical Nurse
0001201805
VA
363LF0000X
Family Nurse Practitioner
Primary
0024170685
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q004515
—
TN
Enumeration date
04/23/2013
Last updated
10/19/2017
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