Provider Demographics
NPI:1356076772
Name:MULLINS, GENNIFER (CD,CPD,CPS)
Entity type:Individual
Prefix:
First Name:GENNIFER
Middle Name:
Last Name:MULLINS
Suffix:
Gender:F
Credentials:CD,CPD,CPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10901 KIRTLEY LN
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-9203
Mailing Address - Country:US
Mailing Address - Phone:540-847-9901
Mailing Address - Fax:
Practice Address - Street 1:10901 KIRTLEY LN
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22553-9203
Practice Address - Country:US
Practice Address - Phone:540-847-9901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula