Provider Demographics
NPI:1962207589
Name:MULKERINS, GEORGIA (APRN)
Entity type:Individual
Prefix:
First Name:GEORGIA
Middle Name:
Last Name:MULKERINS
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 SLACK ST
Mailing Address - Street 2:
Mailing Address - City:PEA RIDGE
Mailing Address - State:AR
Mailing Address - Zip Code:72751-4005
Mailing Address - Country:US
Mailing Address - Phone:479-765-1980
Mailing Address - Fax:479-765-1982
Practice Address - Street 1:2103 SLACK ST
Practice Address - Street 2:
Practice Address - City:PEA RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72751-4005
Practice Address - Country:US
Practice Address - Phone:479-765-1980
Practice Address - Fax:479-765-1982
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR124103363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily