Shannon Rae Mullins, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

176886 Issued in WI

Practice address

2254 Imperial LN
Green Bay, WI 54302

Phone

(715) 661-2206

NPI assigned

Apr 10, 2015

Last updated

Apr 15, 2015By 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 2

Addresses

Other names 1

• Ms. Shannon Rae Mundinger 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": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1891181459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2254 IMPERIAL LN",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54302",
            "telephone_number": "715-661-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2254 IMPERIAL LN",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54302",
            "telephone_number": "715-661-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "SHANNON",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "176886",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "176886",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "MUNDINGER",
            "middle_name": "RAE",
            "prefix": "MS.",
            "credential": "R.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Khali Mohamed Muhumed
• Jennifer Jean Mulhall, PHARM D.
• Valarie Mull
• Muller Eyecare Associates LTD
• John Michael Muller, MD
• Teresa L Mumbrue, A.P.N.P.
• Maranda Mumma
• Vijaya K Munagala, M.D.
• Munoz Family and Cosmetic Dentistry
• Elizabeth Munoz Oliveros, SLP

• Registered Nurse in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.