MRS. KELLY MARIE MULLIKIN PA-C NPI 1225495526

NPI Information

NPI: 1225495526
Provider Name: MRS. KELLY MARIE MULLIKIN, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
2939 ALT 19 # MS 702
PALM HARBOR, FL
ZIP 34683
Phone: (727) 786-5058
Get Directions

MRS. Kelly Marie Mullikin, PA-C is a medical physician assistant in Palm Harbor, FL with 9 years of experience. MRS. Kelly Marie Mullikin, PA-C NPI is 1225495526. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2939 ALT 19 # MS 702
PALM HARBOR, FL
ZIP 34683-928
Phone: (727) 786-5058
Fax: (813) 635-2639

The NPI 1225495526 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/19/2016 and was last updated on 8/17/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		PA9109308	FLORIDA	No
2	363A00000X	Physician Assistant				No
3	363AM0700X	Physician Assistant	Medical	PA9109308	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	108346500	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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