NICHOLAS MULLEN (NPI# 1396232252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396232252 |
| Entity Type | Individual |
| Full Name | NICHOLAS MULLEN |
| Practice Address |
702 E Walnut St Fort Gibson OK 74434-8541 |
| Practice Telephone | 9188693552 |
| Mailing Telephone | 9188693552 |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2018-04-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
702 E WALNUT ST |
| City | FORT GIBSON |
| State | OK |
| Zip Code | 74434-8541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326323296 | Janet Hulbert | Occupational Therapist | 1409 Saddlebrooke Dr, Fort Gibson, OK 74434 | 2011-10-11 |
| 1356643936 | Justin Matthew Wedman | Pharmacist | 114 N. Lee St., Fort Gibson, OK 74434 | 2010-12-02 |
| 1396980546 | Walker & Walker P.l.l.c. | Dentist | 106 Lone Oak Cr, Ft. Gibson, OK 74434 | 2008-12-02 |
| 1548305857 | Christopher Back | Family Medicine | 129 N Lee St., Fort Gibson, OK 74434 | 2007-02-21 |
| 1982794442 | Wanda Ann Teague | Speech-Language Pathologist | 500 South Ross Ave., Fort Gibson, OK 74434 | 2006-10-13 |
| 1891898912 | Scotts Pharmacy LLC | Pharmacy | 1201 S Lee St, Fort Gibson, OK 74434 | 2006-09-06 |
| 1831206671 | Charles Robert Mutch | Family Medicine | 104 Lone Oak Circle, Ft. Gibson, OK 74434 | 2006-08-25 |
| 1073511184 | Brandon Medical, LLC | Prosthetic/Orthotic Supplier | 110 North Lee Street, Fort Gibson, OK 74434 | 2005-07-12 |
| 1265761381 | Holly Jean Dawson | Obstetrics & Gynecology | 108 Lone Oak Cir, Fort Gibson, OK 74434 | 2009-12-19 |
| 1790892529 | Donald M Elgin | Family Medicine | 104 Lone Oak Circle, Ft. Gibson, OK 74434 | 2006-08-25 |
| Find all providers in zip 74434 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972537 | Tamra Lynn Cunningham | Peer Specialist | 764 Sherwin Ave, Ponca City, OK 74604-6112 | 2020-11-05 |
| 1699375691 | Martha Isabel Zapata | Peer Specialist | 5740 E 72nd Ct, Tulsa, OK 74136-7202 | 2020-10-28 |
| 1376143883 | Tina Marie Lopez | Peer Specialist | 933 N Oak St, Ponca City, OK 74601-3218 | 2020-10-26 |
| 1518566264 | Vincent Oaks Cox | Peer Specialist | 3585 S 439, Pryor, OK 74361-9346 | 2020-10-23 |
| 1558960146 | Sarah Elizabeth Walters | Peer Specialist | 2139 W Jasper St Apt B1, Broken Arrow, OK 74011-8028 | 2020-10-23 |
| 1861091548 | Ryan Vanmeter | Peer Specialist | 1965 Ladera Ln, Edmond, OK 73034-9787 | 2020-10-22 |
| 1255930038 | Brandon Loyd Hopkins | Peer Specialist | 446 S Scraper St, Vinita, OK 74301-4250 | 2020-10-22 |
| 1225637366 | Crystal Dawn Adams | Peer Specialist | 200 N Sante Fe Ave, Bartlesville, OK 74003 | 2020-10-20 |
| 1194324491 | Judith Anne Young | Peer Specialist | 3934 Se 27th St, Del City, OK 73115-2620 | 2020-10-19 |
| 1407455892 | Kristen Michelle Stock | Peer Specialist | 804 N Dryden Cir, Stillwater, OK 74075-7108 | 2020-10-18 |
| Find all providers with the same taxonomy | ||||
| City | FORT GIBSON |
| Zip Code | 74434 |
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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.