Provider Demographics
NPI:1730246752
Name:MULHERN, CONTANCE (CRNP)
Entity type:Individual
Prefix:
First Name:CONTANCE
Middle Name:
Last Name:MULHERN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CONTANCE
Other - Middle Name:KEOGH
Other - Last Name:MULHERN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:GROUND SILVERSTEIN BUILDING
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:GROUND SILVERSTEIN BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4206
Practice Address - Country:US
Practice Address - Phone:215-662-6963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP002034C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA002262E64Medicare ID - Type Unspecified
S44860Medicare UPIN