Basic Information
| Provider Information | |||||||||
| NPI: | 1336175728 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MULLINS | ||||||||
| FirstName: | JOANNA | ||||||||
| MiddleName: | ACCURSO | ||||||||
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| Credential: | RN, BSN, ATC. PTA/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5609 E LONGBOAT BLVD | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336154221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9126634478 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5 TAMPA GENERAL CIR | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336063601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132532068 | ||||||||
| FaxNumber: | 8135586084 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN9449259 | FL | Y | Nursing Service Providers | Registered Nurse |
No ID Information.