Provider Demographics
NPI:1700611225
Name:MULLEY, ELIZABETH STONE (PA-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:STONE
Last Name:MULLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:131 OLD ROAD TO NINE ACRE CORNER
Mailing Address - Street 2:MEDICAL OFFICE BUILDING, SUITE 230
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742
Mailing Address - Country:US
Mailing Address - Phone:978-287-8950
Mailing Address - Fax:
Practice Address - Street 1:131 OLD ROAD TO NINE ACRE CORNER
Practice Address - Street 2:MEDICAL OFFICE BUILDING, SUITE 230
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742
Practice Address - Country:US
Practice Address - Phone:978-287-8950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-11-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant