Individual provider Active NPI

Jamie Mullen, APRN

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1891297594
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9322145 Issued in FL
Practice address
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone
(813) 745-4673
Fax
(813) 456-6506
NPI assigned
Mar 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9322145 FL
Nurse Practitioner 363L00000X APRN9322145 FL Primary

Addresses

Primary practice location

12902 Usf Magnolia Dr
Tampa, FL 33612-9416

Mailing address

PO Box 198441
Atlanta, GA 30384-8441
Phone (813) 745-4673

Other identifiers 1

IdentifierTypeStateIssuer
110942000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180620001407 FL Practitioner - Nurse Practitioner 8527313261 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9322145FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Mar 19, 2018 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC Past Accepting new patients

Locations

403 S Kings Ave
Ste 100
Brandon, FL 33511
Phone (813) 982-3460

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500

8787 Bryan Dairy Rd
Ste 210
Largo, FL 33777
Phone (727) 394-1911

1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780

3402 W Dr Martin Luther King Jr Blvd
Fl Cancer
Tampa, FL 33607
Phone (813) 875-3950

3402 W Mlk Blvd
Tampa, FL 33607
Phone (813) 875-3950

3000 Medical Park Dr
Ste 250
Tampa, FL 33613
Phone (813) 632-6220

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1891297594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198441",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848441",
            "telephone_number": "813-745-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129416",
            "telephone_number": "813-745-4673",
            "fax_number": "813-456-6506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "JAMIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-08",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9322145",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9322145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110942000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.