Individual provider Active NPI

Mahnia Kristina McMullen, CRNP, FNP-BC

  • Family Nurse Practitioner
  • Wilmington, DE
National Provider Identifier
1912890997
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP032973 Issued in PA
Practice address
2505 Cedar Ave
Wilmington, DE 19808-3203
Phone
(267) 246-5488
NPI assigned
May 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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 LG-0013240 DE
Family Nurse Practitioner 363LF0000X SP032973 PA Primary

Addresses

Primary practice location

2505 Cedar Ave
Wilmington, DE 19808-3203

Mailing address

2505 Cedar Ave
Wilmington, DE 19808-3203
Phone (267) 246-5488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20260313001385 PA Practitioner - Nurse Practitioner 7911480397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line Emergency Med Associates LLCGroup PAC ID 9234034729, 51 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (484) 337-3583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LG-0013240DEMDFamily Nurse Practitioner
SP032973PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Emergency Med Associates LLC CurrentSince Jan 7, 2026 Accepting new patients

Locations

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Organizations & group practices 1

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": "1748563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1912890997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 CEDAR AVE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198083203",
            "telephone_number": "267-246-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 CEDAR AVE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198083203",
            "telephone_number": "267-246-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "MAHNIA",
        "middle_name": "KRISTINA",
        "credential": "CRNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-30",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0013240",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP032973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.