Provider Demographics
NPI:1174928766
Name:MULLINS, CHRISTINE MICHELLE (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:MICHELLE
Last Name:MULLINS
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 90
Mailing Address - Street 2:
Mailing Address - City:COEBURN
Mailing Address - State:VA
Mailing Address - Zip Code:24230-0090
Mailing Address - Country:US
Mailing Address - Phone:276-455-5556
Mailing Address - Fax:276-455-5557
Practice Address - Street 1:208 FRONT ST W
Practice Address - Street 2:
Practice Address - City:COEBURN
Practice Address - State:VA
Practice Address - Zip Code:24230-3502
Practice Address - Country:US
Practice Address - Phone:276-455-5556
Practice Address - Fax:276-455-5557
Is Sole Proprietor?:No
Enumeration Date:2014-10-26
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19187363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0017141706OtherSTATE LICENSE