Individual provider Active NPI

Susan Maria Mullins, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1609641554
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP028748 Issued in PA
Practice address
9562 James St Unit B
Philadelphia, PA 19114-3056
Phone
(267) 918-4143
NPI assigned
Nov 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP028748 PA Primary

Addresses

Primary practice location

9562 James St Unit B
Philadelphia, PA 19114-3056

Mailing address

9562 James St Unit B
Philadelphia, PA 19114-3056
Phone (267) 918-4143

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SP028748PAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1609641554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9562 JAMES ST UNIT B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191143056",
            "telephone_number": "267-918-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9562 JAMES ST UNIT B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191143056",
            "telephone_number": "267-918-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "SUSAN",
        "middle_name": "MARIA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-21",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP028748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.