Individual
MRS. SHANNON MULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1302 MILLVILLE AVE, HAMILTON, OH 45013-3961
(731) 394-1145
Mailing address
36 PEMBERTON CV, JACKSON, TN 38305-5514
(731) 394-1145
(844) 374-0233
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
3008903
KY
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN.CNP.16422
OH
Other
Enumeration date
08/29/2014
Last updated
08/30/2021
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