Nicholas Mullen

NPI #1396232252 in Fort Gibson, Oklahoma

Provider Information

NPI Number: 1396232252
Entity Type: Individual
Name: Nicholas Mullen
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: Apr 17, 2018
Last Updated: Apr 17, 2018

Practice Location

Address: 702 E WALNUT ST
City: Fort Gibson
State: Oklahoma
ZIP Code: 74434-8541
Phone: (918) 869-3552

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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