Provider Demographics
NPI:1467249052
Name:MULLEN, JENNIFER (DPT)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:MULLEN
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 W GREEN MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-3010
Mailing Address - Country:US
Mailing Address - Phone:573-881-5498
Mailing Address - Fax:
Practice Address - Street 1:3600 COUNTRY CLUB DR STE 530B
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-1060
Practice Address - Country:US
Practice Address - Phone:573-606-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2018028501225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist