Individual
SHELLY JEAN MULLIKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
210 S PINE ST, BURLINGTON, WI 53105-1914
(262) 763-7177
(262) 763-9860
Mailing address
210 S PINE ST, BURLINGTON, WI 53105-1914
(262) 763-7177
(262) 763-9860
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11046
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
318362
NABP
WI
Enumeration date
03/05/2015
Last updated
03/05/2015
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