Kelly M Mullen, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

917756 Issued in MS

Practice address

158 Pinecrest Dr
Poplarville, MS 39470-6442

Phone

(601) 522-0093

NPI assigned

Jun 22, 2026

Last updated

Jun 22, 2026By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1782086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1689500324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 PINECREST DR",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394706442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 PINECREST DR",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394706442",
            "telephone_number": "601-522-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-22",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "917756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Poplarville, MS
• Providers in Poplarville, MS by specialty
• Registered Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.