Provider Demographics
NPI:1780358903
Name:MULLINS, MARY J (PA-C)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:J
Last Name:MULLINS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:4 BERKELEY LN
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-4254
Mailing Address - Country:US
Mailing Address - Phone:978-382-3201
Mailing Address - Fax:
Practice Address - Street 1:4 BERKELEY LN
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-4254
Practice Address - Country:US
Practice Address - Phone:978-382-3201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-08-03
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant