Basic Information
| Provider Information | |||||||||
| NPI: | 1578895447 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MULLINS | ||||||||
| FirstName: | NATHAN | ||||||||
| MiddleName: | HERMAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18 WEDGEFIELD DR | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288062226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282528748 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 18 WEDGEFIELD DR | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282528748 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2010 | ||||||||
| LastUpdateDate: | 01/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0000X | 2015-02143 | NC | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics | 2084A0401X | 2015-02143 | NC | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Medicine | 207VG0400X | 2015-02143 | NC | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | 207V00000X | 2015-02143 | NC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 1578895447 | 05 | NC | MEDICAID |