Provider Demographics
NPI:1215143946
Name:MULKERN, REBECCA JONES (ND)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:JONES
Last Name:MULKERN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03818-0099
Mailing Address - Country:US
Mailing Address - Phone:603-447-3070
Mailing Address - Fax:
Practice Address - Street 1:200 EAST SIDE RD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03818-0099
Practice Address - Country:US
Practice Address - Phone:603-447-3070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath