PRISCILLA BROOKE MULLICAN (NPI# 1093358228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093358228 |
| Entity Type | Individual |
| Full Name | PRISCILLA BROOKE MULLICAN |
| Practice Address |
3326 Front St Ste C Winnsboro LA 71295-6418 |
| Mailing Address |
Po Box 1362 Winnsboro LA 71295-1362 |
| Practice Telephone | 3184357333 |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2019-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
202877 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3326 FRONT ST STE C |
| City | WINNSBORO |
| State | LA |
| Zip Code | 71295-6418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851926968 | Ginger Martin | Nurse Practitioner | 3326 Front St Ste C, Winnsboro, LA 71295-6418 | 2020-03-09 |
| 1982243523 | Jennifer Peterson Salter | Occupational Therapist | 3326 Front St Ste C, Winnsboro, LA 71295-6418 | 2019-12-30 |
| 1447894530 | Penny Sue James | Specialist/Technologist | 3326 Front St Ste C, Winnsboro, LA 71295-6418 | 2019-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295365963 | Allyson Maxwell | Speech-Language Pathologist | 2330 Hwy La 15, Winnsboro, LA 71295 | 2020-01-22 |
| 1326564311 | Geaux Fit of La LLC | Physical Therapist | 3630 Front St, Winnsboro, LA 71295 | 2017-08-21 |
| 1407372220 | Pauline T Powell | Case Manager/Care Coordinator | 920 Maple St, Winnsboro, LA 71295 | 2017-08-15 |
| 1831613801 | Desi D Hoard | Counselor | 2513 Martin Dr., Winnsboro, LA 71295 | 2017-08-01 |
| 1174975213 | Tanya Grant | Case Manager/Care Coordinator | 2411 Gary St, Winnsboro, LA 71295 | 2016-07-12 |
| 1285085050 | Casey Ryan | Physical Therapist | 6340 Hwy 4, Winnsboro, LA 71295 | 2016-06-23 |
| 1003264649 | Ta'erica Manuel | Counselor | 1113 Lavender Dr, Winnsboro, LA 71295 | 2016-05-24 |
| 1073969168 | Ladill Majors | Counselor | 1459 Highway 618, Winnsboro, LA 71295 | 2016-05-09 |
| 1386090587 | Lakeisha Crockett | Case Manager/Care Coordinator | 2406c West St, Winnsboro, LA 71295 | 2016-05-06 |
| 1982064069 | Refford Oliver Sr. | Counselor | 2406 West St, Winnsboro, LA 71295 | 2016-03-02 |
| Find all providers in zip 71295 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730619529 | Shelby Smotherman Vascocu | Nurse Practitioner | 101 Fair Ave, Winnsboro, LA 71295-2117 | 2017-06-14 |
| 1972907160 | Lynzie Nicole Henry | Nurse Practitioner | 719 W Coke Rd # Mob2, Winnsboro, TX 75494-3011 | 2014-10-16 |
| 1316378805 | Stephanie Greer Johnson | Nurse Practitioner | 2104 Loop Road Ste C, Franklin Medical Rural Health, Winnsboro, LA 71295 | 2013-12-09 |
| 1023444551 | Kristal Lare Spencer | Nurse Practitioner | 719 W Coke Rd Ste 6, Winnsboro, TX 75494-3060 | 2013-09-16 |
| 1902991326 | Tanya R Cobb | Nurse Practitioner | 2106 A Loop Road, Winnsboro, LA 71295 | 2006-10-03 |
| 1043318991 | Kimberly R Fannin - Trisler | Nurse Practitioner | 2106 Loop Rd # C, Winnsboro, LA 71295-3344 | 2006-09-21 |
| 1053922674 | Samantha J Wood | Nurse Practitioner | 2106 Loop Rd, Winnsboro, LA 71295-3344 | 2020-08-17 |
| 1699391623 | Rang Kim | Nurse Practitioner | 3326 Front St, Winnsboro, LA 71295-6406 | 2020-06-25 |
| 1396369815 | Leslie Madden | Nurse Practitioner | 5745 Highway 17, Winnsboro, LA 71295-5688 | 2020-06-01 |
| 1851926968 | Ginger Martin | Nurse Practitioner | 3326 Front St Ste C, Winnsboro, LA 71295-6418 | 2020-03-09 |
| Find all providers in WINNSBORO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.