Provider Demographics
NPI:1720508971
Name:MULLINS, GWENDOLIN B (FNP)
Entity type:Individual
Prefix:
First Name:GWENDOLIN
Middle Name:B
Last Name:MULLINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:GWENDOLIN
Other - Middle Name:B
Other - Last Name:SHAFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 COMMERCE ST STE 700
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37201-1835
Mailing Address - Country:US
Mailing Address - Phone:615-627-2293
Mailing Address - Fax:888-494-2588
Practice Address - Street 1:5201 KINGSTON PIKE STE 6
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5011
Practice Address - Country:US
Practice Address - Phone:865-978-6182
Practice Address - Fax:855-737-5542
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN120275163W00000X
TN22722363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse