Provider Demographics
NPI:1972318236
Name:MULLINS, LOREA ELLEN (BA)
Entity type:Individual
Prefix:
First Name:LOREA
Middle Name:ELLEN
Last Name:MULLINS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 OAK RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-8595
Mailing Address - Country:US
Mailing Address - Phone:606-910-4308
Mailing Address - Fax:606-439-2861
Practice Address - Street 1:91 OAK RIDGE CT
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-8595
Practice Address - Country:US
Practice Address - Phone:606-910-4308
Practice Address - Fax:606-439-2861
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator