Basic Information
| Provider Information | |||||||||
| NPI: | 1881675361 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MULLER | ||||||||
| FirstName: | M. | ||||||||
| MiddleName: | ANNIE | ||||||||
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| Credential: | DNP, FNP/APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3239 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295023239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437776870 | ||||||||
| FaxNumber: | 8437776871 | ||||||||
| Practice Location | |||||||||
| Address1: | 3015 W PALMETTO ST | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295015935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437776870 | ||||||||
| FaxNumber: | 8437776871 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2005 | ||||||||
| LastUpdateDate: | 04/13/2010 | ||||||||
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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 | 363L00000X | 2583 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 226111 | 01 | SC | MEDCOST | OTHER | NP1556 | 05 | SC | MEDICAID | 20-2935692-062 | 01 | SC | BCBS | OTHER | AA47218552 | 01 | SC | MEDICARE PTAN | OTHER | 20-2935692-063 | 01 | SC | BCBS | OTHER |