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Matthew Mullen, NURSEPRACTITIONER
Family Nurse Practitioner in South Lake Tahoe, California
NPI 1780358929

Matthew Mullen is a Family Nurse Practitioner based in South Lake Tahoe, CA and is specialized in Family. Matthew Mullen practices in South Lake Tahoe, CA and has the professional credentials of NURSEPRACTITIONER. The NPI Number for Matthew Mullen is 1780358929 and holds a License No. 95017939 (California).

The current practice location address for Matthew Mullen is 2201 South Ave, South Lake Tahoe, CA and can be reached out via phone at 530-543-5623.

Location: 2201 South Ave, South Lake Tahoe, CA, 96150-5275
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1780358929
Provider Name
Matthew Mullen
Credential
NURSEPRACTITIONER
Provider Entity Type
Individual
Gender
Male
Address
2201 South Ave, South Lake Tahoe, CA, 96150-5275
Phone Number
530-543-5623
Fax Number
Provider Enumeration Date
08/02/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2201 South Ave
City
South Lake Tahoe
State
California
Zip
96150-7025
Phone Number
530-543-5623
Fax Number
person
Provider Business Mailing Address Details
Address
2201 South Ave
City
South Lake Tahoe
State
California
Zip
96150-7025
Phone Number
530-543-5623
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
95017939 (California)
Definition
Definition to come...
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