Provider Demographics
NPI:1952295826
Name:MULLINS, KRISTI DENISE
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:DENISE
Last Name:MULLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 ELSWICK FORK RD
Mailing Address - Street 2:
Mailing Address - City:LICK CREEK
Mailing Address - State:KY
Mailing Address - Zip Code:41540-8110
Mailing Address - Country:US
Mailing Address - Phone:606-422-6208
Mailing Address - Fax:
Practice Address - Street 1:911 BIPASS ROAD
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501
Practice Address - Country:US
Practice Address - Phone:606-430-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4032427363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care