Provider Demographics
NPI:1932418704
Name:MCMULLEN, KATRINA K (WHNP)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:K
Last Name:MCMULLEN
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 DEXTER DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5294
Mailing Address - Country:US
Mailing Address - Phone:972-596-3424
Mailing Address - Fax:972-596-3272
Practice Address - Street 1:4700 DEXTER DR
Practice Address - Street 2:SUITE 400
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5294
Practice Address - Country:US
Practice Address - Phone:972-596-3424
Practice Address - Fax:972-596-3272
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX678593363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX282195102Medicaid
TX282195103Medicaid
TX282195101Medicaid
TXTXB115237Medicare PIN
TXP00945887Medicare PIN
TX282195102Medicaid
TXTXB115235Medicare PIN