KIMBERLEY MULLIN (NPI# 1124437108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124437108 |
| Entity Type | Individual |
| Full Name | KIMBERLEY MULLIN |
| Credential | PA-C |
| Practice Address |
1021 Bandana Blvd E Suite 100 Saint Paul MN 55108-5113 |
| Practice Telephone | 6512419700 |
| Practice Fax Number | 6512413681 |
| Mailing Telephone | 6512419700 |
| Mailing Fax Number | 6512413681 |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2014-08-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2138 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1021 BANDANA BLVD E SUITE 100 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55108-5113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700867967 | Charles Edward Kath | Dentist | 1021 Bandana Blvd E, Saint Paul, MN 55108-5113 | 2005-11-07 |
| 1871946459 | Rachel Zerby | Audiologist | 1021 Bandana Blvd E, Suite 100, Saint Paul, MN 55108-5113 | 2016-07-19 |
| 1285085274 | Megan Elyse Welborn | Dentist | 1021 Bandana Blvd E, Saint Paul, MN 55108-5113 | 2016-06-30 |
| 1821451774 | Edlund Dental, LLC | Dentist | 1021 Bandana Blvd E, Suite #105, Saint Paul, MN 55108-5113 | 2016-03-29 |
| 1417344110 | Laurel Urquhart Welch | Physical Therapist | 1021 Bandana Blvd E, Suite 123, Saint Paul, MN 55108-5113 | 2015-04-20 |
| 1770990467 | Gabrielle Rivard | Physician Assistant | 1021 Bandana Blvd E, Saint Paul, MN 55108-5113 | 2014-07-15 |
| 1376976332 | Tara N Peacock | Nurse Practitioner | 1021 Bandana Blvd E, Suite 100, Saint Paul, MN 55108-5113 | 2013-08-14 |
| 1831521848 | Hnouchi Patricia Lochungvu | Family Medicine | 1021 Bandana Blvd E, Suite #100, Saint Paul, MN 55108-5113 | 2013-07-31 |
| 1447537162 | Michelle Josephine Parra | Physical Therapist | 1021 Bandana Blvd E, Suite 123, Saint Paul, MN 55108-5113 | 2011-11-09 |
| 1326353731 | Sarah A Siemer | Physical Therapist | 1021 Bandana Blvd E, Saint Paul, MN 55108-5113 | 2010-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306490677 | Kyle Leonard Bernier | Student in an Organized Health Care Education/Training Program | 1295 Bandana Blvd W, Suite 210, St. Paul, MN 55108 | 2019-07-25 |
| 1356870778 | Kathleen Louise Kocon | Marriage & Family Therapist | 2230 Como Ave., Saint Paul, MN 55108 | 2017-06-08 |
| 1871965830 | Jill Hansen | Specialist | 1449 Clevland Ave N, The Emily Program, Saint Paul, MN 55108 | 2015-10-29 |
| 1871821140 | Angela Joyce Anderson | Speech-Language Pathologist | 2266 Hillside Avenue, Saint Paul, MN 55108 | 2009-11-25 |
| 1265769418 | Dakota Baker | Counselor | 1360 Energy Park Drive Suite 340, St. Paul, MN 55108 | 2009-11-09 |
| 1255583449 | Suzanne Elizabeth Trunnell | Nurse Practitioner | 1020 Bandana Blvd. W, Aspen Medical Group--bandana Square, St. Paul, MN 55108 | 2008-10-21 |
| 1982851358 | Kimberly Joy Bahma | Pharmacist | 1295 Bandana Blvd, Suite 335, Saint Paul, MN 55108 | 2008-08-27 |
| 1952566093 | Caring Professionals Homecare, LLC | Home Health | 1543 Como Ave Ste 101, Saint Paul, MN 55108 | 2008-07-28 |
| 1700077344 | Archana Mani | Dentist | 1021 Bandana Blvd E Ste 121, Saint Paul, MN 55108 | 2007-08-08 |
| 1457554735 | Catherine Lawrence Scharlau | Psychologist | 1295 Bandana Blvd. North, Aspen Medical Group-behavioral Health, St. Paul, MN 55108 | 2007-06-06 |
| Find all providers in zip 55108 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265284 | Foua Vang | Physician Assistant | 689 County Road D E Apt 302, Saint Paul, MN 55117-1263 | 2020-11-08 |
| 1679107841 | Kelsey Locken | Physician Assistant | 2285 University Ave W Unit 161, Saint Paul, MN 55114-1645 | 2020-02-26 |
| 1497395719 | Demitri Nichelle Gockel | Physician Assistant | 750 Otto Ave Unit 2242, Saint Paul, MN 55102-5042 | 2020-01-14 |
| 1245870203 | Ashley Kay Warner | Physician Assistant | 640 Jackson St # 11102f, Saint Paul, MN 55101-2595 | 2020-01-07 |
| 1275171795 | Keith Fertey Moy | Physician Assistant | 594 Montrose Ln, Saint Paul, MN 55116-1158 | 2019-12-16 |
| 1609417757 | Mh 101, PC | Physician Assistant | 1999 Shepard Rd, Saint Paul, MN 55116-3210 | 2019-09-30 |
| 1760048946 | Amity Alice Carlson | Physician Assistant | 1600 University Ave W Ste 205, Saint Paul, MN 55104-3825 | 2019-05-14 |
| 1740747872 | Angela Marie Schlangen | Physician Assistant | 435 Phalen Blvd., Mail Stop 51103c, Saint Paul, MN 55130-5302 | 2019-02-25 |
| 1922590488 | Diane Mcleod | Physician Assistant | Healthpartners Regions Specialty Clinics, 640 Jackson St - Mail Stop 11109e, Saint Paul, MN 55101 | 2018-05-31 |
| 1649720533 | Jeffrey Charles Otis | Physician Assistant | 405 Nebraska Ave E, Saint Paul, MN 55130-3226 | 2016-10-04 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55108 |
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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.