Individual
EBONY MCMULLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
103 FINANCIAL PL STE 100, ELIZABETHTOWN, KY 42701-4471
(251) 242-1349
Mailing address
1054 WETTERAU AVE, LOUISVILLE, KY 40217-1554
(251) 242-1349
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4004989
KY
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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