Most Relevant Information
Provider Data
| NPI Number: | 1003450503 |
| Provider Name: | STEPHANIE MULLEN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 317893 |
Most Important Dates
| Enumeration Date: | 10/29/2019 |
| Last Updated: | 10/29/2019 |
Provider Practice Location
2172 COLLEGE AVE
ELMIRA HEIGHTS
NY
149031287
Practice Location Phone/Fax
| Phone: | 1607483259 |
| Fax: |
Provider Mailing Location
2172 COLLEGE AVE
ELMIRA HEIGHTS
NY
149031287
Provider Mailing Phone/Fax
| Phone: | 1607483259 |
| Fax: |