Provider Demographics
NPI:1225832397
Name:MULLINAX, JAMES ERIC
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ERIC
Last Name:MULLINAX
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 36TH AVE W
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-6070
Mailing Address - Country:US
Mailing Address - Phone:701-609-7405
Mailing Address - Fax:
Practice Address - Street 1:1818 36TH AVE W
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-6070
Practice Address - Country:US
Practice Address - Phone:701-609-7405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider