Provider Demographics
NPI:1528798568
Name:MULLINS, JOSEPH ANDREW (BSN, RN, SRNA)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ANDREW
Last Name:MULLINS
Suffix:
Gender:M
Credentials:BSN, RN, SRNA
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:353 EASTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:RAVENSWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26164-8642
Mailing Address - Country:US
Mailing Address - Phone:304-531-9377
Mailing Address - Fax:
Practice Address - Street 1:3110 MACCORKLE AVE SE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1210
Practice Address - Country:US
Practice Address - Phone:304-388-9950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X, 2255A2300X
VA0024190273367500000X
WV97080163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine