| Doctor Name: | MARK MULLINS |
| NPI Number: | 1114322955 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | F.N.P. |
| License Number: | APRN82732-NP-C |
| Business Practice Address: | 2 Chateau Ln Barboursville, WV - 255041626 |
| Business Phone Number: | 3047369090 |
| Business Fax Number: | |
| Mailing Address: | Po Box 333, JOLO |
| State: | WV |
| Postal Code: | 248500333 |
| Phone Number: | 6069224778 |
| Fax Number: | |
| NPI Enumeration Date: | 10/22/2014 |
| NPI Last Update Date: | 10/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | APRN82732-NP-C |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |