Tiara J Mullen, APRN
Nurse Practitioner, Family in Peoria, IL. Individual provider (NPI-1).
NPI number1164062196
StatusActive
Last updated in NPPESSep 29, 2026
Details
- NPI
- 1164062196
- Entity type
- Individual (NPI-1)
- Name
- Ms. Tiara J Mullen
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 7, 2020
- Certification date
- Jul 29, 2026
- Last updated
- Sep 29, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 209020366 | IL | Yes |
Practice location
420 Ne Glen Oak Ave Ste 401Peoria, IL 61603-3112
Phone 309-676-8123 · Fax 309-676-8455
Mailing address
420 Ne Glen Oak Ave Ste 401Peoria, IL 61603-3112
Phone 309-676-8123 · Fax 309-676-8455
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