Provider Demographics
NPI:1215790076
Name:MULL, JOCELYN MICHELLE
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:MICHELLE
Last Name:MULL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 SUMMIT RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07821-2057
Mailing Address - Country:US
Mailing Address - Phone:973-903-8511
Mailing Address - Fax:
Practice Address - Street 1:13 SUMMIT RD
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:NJ
Practice Address - Zip Code:07821-2057
Practice Address - Country:US
Practice Address - Phone:973-903-8511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program