Individual provider Active NPI

Patrice Ann Mullany, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1457381048
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
303275 Issued in CA
Practice address
11301 Wilshire Blvd
Los Angeles, CA 90073-1003
Phone
(310) 478-3711
NPI assigned
Jul 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 303275 CA Primary

Addresses

Primary practice location

11301 Wilshire Blvd
Los Angeles, CA 90073-1003

Mailing address

1161 Amherst Ave
Los Angeles, CA 90049-5894
Phone (310) 826-1943

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
303275CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457381048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 AMHERST AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495894",
            "telephone_number": "310-826-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900731003",
            "telephone_number": "310-478-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLANY",
        "first_name": "PATRICE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "303275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.