MR. JOHN WILLIAM MULLENS AGACNP NPI 1710684428

NPI Information

NPI: 1710684428
Provider Name: MR. JOHN WILLIAM MULLENS, AGACNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
200 S ENOTA DR NE STE 100
GAINESVILLE, GA
ZIP 30501
Phone: (770) 534-2020
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MR. John William Mullens, AGACNP is an acute care nurse practitioner in Gainesville, GA with 2 years of experience. MR. John William Mullens, AGACNP NPI is 1710684428. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MERCER UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2022

The provider's business location address is:

200 S ENOTA DR NE STE 100
GAINESVILLE, GA
ZIP 30501-466
Phone: (770) 534-2020

The NPI 1710684428 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 2/13/2023 and was last updated on 5/24/2023.

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	163W00000X	Registered Nurse		RN289159	GEORGIA	No
2	363LG0600X	Nurse Practitioner	Gerontology	2023000291	GEORGIA	No
3	363LA2100X	Nurse Practitioner	Acute Care	RN289159	GEORGIA	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	2023000291	OTHER	GEORGIA	AMERICAN NURSING CREDENTIALING CENTER
2	RN289159	OTHER	GEORGIA	GEORGIA BOARD OF NURSING

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: 5/5/2024

NPI Synchronization or Removal

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