MARILYN KAY MULLANE (NPI# 1821091547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821091547 |
| Entity Type | Individual |
| Full Name | MARILYN KAY MULLANE |
| Credential | PA-C |
| Practice Address |
390 W Salem Ave Winston Salem NC 27101-5861 |
| Mailing Address |
Po Box 751803 Charlotte NC 28275-1803 |
| Practice Telephone | 3367212375 |
| Practice Fax Number | 3367212394 |
| Mailing Telephone | 3367660547 |
| Mailing Fax Number | 3367660549 |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2019-01-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 101138 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
101138 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8101706 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 105 Stadium Oaks Dr, Clemmons, NC 270128962 | 3367660547 | 3367660549 |
| Street Address |
390 W SALEM AVE |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27101-5861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073076956 | Novant Medical Group, Inc. | Family Medicine | 390 W Salem Ave, Winston Salem, NC 27101-5861 | 2019-04-09 |
| 1841705688 | Lura Elizabeth Mcmurray | Nurse Practitioner | 390 W Salem Ave, Winston Salem, NC 27101 | 2017-12-01 |
| 1720461544 | Erica R Robbins | Nurse Practitioner | 390 W Salem Ave, Winston Salem, NC 27101-5861 | 2015-06-30 |
| 1851593792 | Jennifer A Layton | Physician Assistant | 390 W Salem Ave, Winston Salem, NC 27101-5861 | 2007-06-04 |
| 1447463682 | Christian B Moretz | Family Medicine | 390 W Salem Ave, Winston Salem, NC 27101-5861 | 2007-05-07 |
| 1316075963 | Cecilie Macosko | Family Medicine | 390 W Salem Ave, Winston Salem, NC 27101-5861 | 2007-03-02 |
| 1700962321 | Kristen E Rinkenberg | Physician Assistant | 390 W Salem Ave, Winston Salem, NC 27101-5861 | 2006-10-27 |
| 1417038738 | Larry A Hollar Jr. | Family Medicine | 390 W Salem Ave, Winston Salem, NC 27101-5861 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003421876 | Annie Carolina Mccollum | Occupational Therapist | 3 S Martin Luther King Jr Dr, Winston-salem, NC 27101 | 2020-09-09 |
| 1891321337 | Philippe Ayres | Personal Emergency Response Attendant | 475 Vine St., Bowman Gray Center for Medical Education, Winston-salem, NC 27101 | 2020-03-17 |
| 1497385595 | Aereil Moore | Counselor | 655 West 4th St, Winston Salem, NC 27101 | 2020-01-17 |
| 1619519428 | Brandi Melissa Decriscio | Nurse Practitioner | 1200 N Martin Luther King Jr Drive, Winston-salem, NC 27101 | 2019-10-14 |
| 1316502909 | Burke Street Chiropractic, Pllc | Chiropractor | 1016 Burke St., Winston-salem, NC 27101 | 2019-05-08 |
| 1790349728 | Nakia Carter | Counselor | 1o1o W. Northwest Boulevard, Winston-salem, NC 27101 | 2019-04-25 |
| 1003391251 | Hannah Fortwengler Rainey | Nurse Anesthetist, Certified Registered | Medical Center Blvrd, Winston-salem, NC 27101 | 2018-10-03 |
| 1750875928 | Susan Wilhelm Patterson | Nurse Practitioner | 1200 Martin Luther King Jr Dr, Winston-salem, NC 27101 | 2018-06-20 |
| 1194228049 | Anjanette Gilley Benjamin | Counselor | 650 Highland Ave Ste 1000, Winston Salem, NC 27101 | 2018-03-16 |
| 1376054627 | Paulisha Da-shawna Mcintyre | Social Worker | 650 Highland Ave Ste 101, Winston Salem, NC 27101 | 2017-10-13 |
| Find all providers in zip 27101 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598375032 | Anthony Gentile | Physician Assistant | 2632 Wynbrook Dr, Winston Salem, NC 27103-8005 | 2020-08-07 |
| 1376152074 | Meera Shah | Physician Assistant | 3288 Robinhood Rd Ste 202, Winston Salem, NC 27106-5464 | 2020-07-28 |
| 1770118457 | Heather Leigh Bissell | Physician Assistant | 153 Lavender Ln, Winston Salem, NC 27107-6023 | 2020-03-03 |
| 1245899806 | Cheryl L Sizer | Physician Assistant | Wake Forest Baptist Health 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2019-06-07 |
| 1235606575 | Vincent James Alderete | Physician Assistant | Wake Forest Baptist Health 1 Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2018-10-25 |
| 1386127538 | Frederick Keith Stirewalt | Physician Assistant | Medical Center Blvd Faithhealth, Winston Salem, NC 27157-0001 | 2018-09-13 |
| 1164936852 | Lindsay Webster | Physician Assistant | 10479 Nc-109, 107a, Winston Salem, NC 27107 | 2017-11-17 |
| 1518477694 | Raul Canchari Ames | Physician Assistant | 512 Waughtown St, Winston Salem, NC 27127-2236 | 2017-10-03 |
| 1922528611 | Devon Adams | Physician Assistant | 1 Medical Center Blvd Gastroenterology Dept, Winston Salem, NC 27157-7223 | 2017-06-22 |
| 1053862474 | Seguin Warwick Beuerlein | Physician Assistant | 2425 Riley Forest Dr, Winston Salem, NC 27127-7573 | 2016-10-20 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27101 |
Please comment or provide details below to improve the information on MARILYN KAY MULLANE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.