Provider Demographics
NPI:1386242998
Name:MULLINS, BRANDI LYNEE (APRN)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:LYNEE
Last Name:MULLINS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:LYNEE
Other - Last Name:MULLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:139 WHICKER DR
Mailing Address - Street 2:
Mailing Address - City:RUSSELL SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:42642-9656
Mailing Address - Country:US
Mailing Address - Phone:606-219-0542
Mailing Address - Fax:
Practice Address - Street 1:139 WHICKER DR
Practice Address - Street 2:
Practice Address - City:RUSSELL SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:42642-9656
Practice Address - Country:US
Practice Address - Phone:606-219-0542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3015350363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care