Jacqueline Ruth Mullen, M.H.A.,R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

576894-01 Issued in NY

Practice address

2787 Hiltonwood Road
Baldwinsville, NY 13027

Phone

(315) 420-3659

NPI assigned

Aug 31, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other names 1

• Jacqueline Ruth Ascenzi Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1275201733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2787 HILTONWOOD ROAD",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "13027",
            "telephone_number": "315-420-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2787 HILTONWOOD ROAD",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "13027",
            "telephone_number": "315-420-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "JACQUELINE",
        "middle_name": "RUTH",
        "credential": "M.H.A.,R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "NY",
            "license": "576894-01",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NY",
            "license": "576894-01",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "576894-01",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "576894-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "ASCENZI",
            "middle_name": "RUTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joel Patrick Monahan, LMHC, CASAC
• Louise Ann Mongelluzzo, PA-C
• Kyleigh M Moore
• Leila C. Moore, DPT
• Karen H Mullarney, R.N.
• Rebecca Murphy, RN
• Bridget Anne Muscatello, REGISTERED NURSE, BS
• Rhonda F Museums, RNNP-C
• Rocco Nalli III, M.A., C.A.S.
• Derek Natoli, PARAMEDIC

• Registered Nurse in Baldwinsville, NY
• Providers in Baldwinsville, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.