| NPI | 1740590371 |
|---|---|
| Former Name | CHERI PHYLLIS MULLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP011459) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC A1010035) |
| 163W00000X Registered Nurse (Licence: PA RN626571) | |
| Enumeration Date | 2010-10-17 |
| Last Update Date | 2016-12-16 |