Provider Demographics
NPI:1417226994
Name:MULLIKIN, MARIA ELVIRA (NP-C)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ELVIRA
Last Name:MULLIKIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 20994
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003
Mailing Address - Country:US
Mailing Address - Phone:307-633-6191
Mailing Address - Fax:307-631-7469
Practice Address - Street 1:214 EAST 23RD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001
Practice Address - Country:US
Practice Address - Phone:307-633-6191
Practice Address - Fax:307-631-7469
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY24884.1127363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily