Kristina L. Mullen, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA10004818 Issued in WA

Practice address

2320 Freeway Drive
Mount Vernon, WA 98273

Phone

(360) 814-6100

Fax

(360) 814-6110

NPI assigned

Oct 2, 2006

Last updated

Jul 1, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kristina L. Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Pacific Rim Orthopaedic Surgeons

  • Orthopaedic Surgery Physician
  • Bellingham, WA
  • NPI 1417977208
  NPD (past)
• Walker County Hospital Corporation

  dba Huntsville Memorial Hospital

  • Rural Health Clinic/Center
  • Huntsville, TX
  • NPI 1972628816
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1588757306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "address_2": "C/O CREDENTIALING",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-428-2500",
            "fax_number": "360-428-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 FREEWAY DRIVE",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "98273",
            "telephone_number": "360-814-6100",
            "fax_number": "360-814-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "KRISTINA",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10004818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "JOHNSON",
            "middle_name": "L.",
            "prefix": "MISS",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mt. Vernon Operations, LLC (Life Care Center of Mount Vernon)
• Ellen Marie Muench, SLP
• Abbey Mulder, OTR
• Macy M Mullen-Racca, LMT
• Jodi Lee Mullen
• Melissa Suzanne Fundora Mullen, MA
• Michael Bryan Mullen, MD
• Lucia C Muller, M.D.
• Multi Med Management Corp (Health Med Centers)
• Morgan Muncey-Buckley

• Surgical Physician Assistant in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.