National Provider Identifier
Staci M Mullen, RN
Staci M Mullen, RN is listed in the NPPES registry with a primary specialty of Registered Nurse in Canaseraga, NY and a listed phone number of (607) 545-6197.
Profile Overview
- NPI
- 1154935682
- Provider Type
- Individual
- Primary Specialty
- Registered Nurse
- Enumeration Date
- September 02, 2020
- Last Updated
- September 02, 2020
Practice Location
- 49 South Church St
- Canaseraga, NY 14822
Phone: (607) 545-6197
Mailing Address
- PO Box 112
- Canaseraga, NY 14822-0112
Specialties
- Registered Nurse (163W00000X)
Full Record
- NPI
- 1154935682
- Entity Type
- Individual
- Last Name
- Mullen
- First Name
- Staci
- Middle Name
- M
- Credential
- RN
- Provider Other Last Name
- French
- Provider Other First Name
- Staci
- Provider Other Middle Name
- M
- Provider Other Credential Text
- RN
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- PO Box 112
- Mailing City
- Canaseraga
- Mailing State
- NY
- Mailing ZIP Code
- 14822-0112
- Mailing Country
- US
- Mailing Phone
- (607) 545-6197
- Practice Street Address
- 49 South Church St
- Practice City
- Canaseraga
- Practice State
- NY
- Practice ZIP Code
- 14822
- Practice Country
- US
- Practice Phone
- (607) 545-6197
- Enumeration Date
- September 02, 2020
- Last Updated
- September 02, 2020
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- August 27, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Registered Nurse (163W00000X)