Mullikin, Kelly Marie

Mullikin, Kelly Marie is an individual health care provider with primary practice located at 2939 Alt 19 # Ms 702 , Palm Harbor FL 34683-1928. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Mullikin, Kelly Marie can be contacted via phone (727) 786-5058.

Contact Information

Primary practice address
2939 Alt 19 # Ms 702 Palm Harbor FL 34683-1928
Phone: (727) 786-5058
Fax: (813) 635-2639
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9109308 Florida
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9109308 Florida

Profile Details

NPI number 1225495526
LBN Legal business name Mullikin, Kelly Marie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2016
Last updated Aug 17th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225495526 NPPES
Florida MEDICAID 108346500

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