| Doctor Name: | CONNIE MULLINS |
| NPI Number: | 1497975817 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHYSICIAN EXTENDER |
| License Number: | 079592 |
| Business Practice Address: | 1002 Dogwood Drive Zebulon, NC - 27597 |
| Business Phone Number: | 9194044036 |
| Business Fax Number: | |
| Mailing Address: | 1213 Pilot-riley Road, ZEBULON |
| State: | NC |
| Postal Code: | 275977798 |
| Phone Number: | 9192690512 |
| Fax Number: | |
| NPI Enumeration Date: | 04/26/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 079592 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |