Provider Demographics
NPI:1194069591
Name:MULVIHILL, CONNIE ANITA (NP)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:ANITA
Last Name:MULVIHILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:304 TANGER DR
Mailing Address - Street 2:STE 221
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160
Mailing Address - Country:US
Mailing Address - Phone:972-535-6493
Mailing Address - Fax:972-551-1418
Practice Address - Street 1:304 TANGER DR
Practice Address - Street 2:STE 221
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160
Practice Address - Country:US
Practice Address - Phone:972-535-6493
Practice Address - Fax:972-551-1418
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX823172363LF0000X
LAAP06884363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1194069591OtherNPI