Staci M Mullen, RN
Registered Nurse in Canaseraga, NY. Individual provider (NPI-1).
NPI number1154935682
StatusActive
Last updated in NPPESSep 2, 2020
Details
- NPI
- 1154935682
- Entity type
- Individual (NPI-1)
- Name
- Staci M Mullen
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 2, 2020
- Certification date
- Aug 27, 2020
- Last updated
- Sep 2, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 617017 | NY | Yes |
Other names
- Staci M French (Former Name)
Practice location
49 South Church StCanaseraga, NY 14822
Phone 607-545-6197
Mailing address
Po Box 112Canaseraga, NY 14822-0112
Phone 607-545-6197
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