Tiffany Beth Mullins, RN

Individual provider Active NPI Registered Nurse · Pound, VA

NPI 1003402629 · NPPES record last updated Dec 17, 2020

Key facts

NPI
1003402629
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
0001228247 (VA)
Practice address
11231 Indian Creek Rd
Pound, VA 24279
Phone
(276) 796-2200
Fax
(276) 796-2202
NPI assigned
Dec 17, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001228247VAMDRegistered Nurse
0230012735VAMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Hancock Lambert Pharmacy Inc. Current
since Feb 7, 2021
Accepting new patients
Tyfan Inc. Past
since Dec 22, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 0230012735 VA
Registered Nurse 163W00000X 0001228247 VA Yes

Addresses

Primary practice location

11231 Indian Creek Rd
Pound, VA 24279

Mailing address

PO Box 1480
Pound, VA 24279-1480
Phone (276) 796-2200

Other providers in Pound, VA

All providers in Pound, VA · Registered Nurse in Virginia

Sources for this page

Verify at the official NPI Registry.