MILDRED POTTER STULL RN, NP - NPI 1215095468 - Nurse Practitioner in Jackson, GA

Q: What is Mildred Stull's NPI number?

The NPI number for Mildred Stull is 1215095468. It was assigned to this individual provider in the NPPES registry on December 4, 2006.

Q: What is Mildred Stull's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Mildred Stull was last updated on July 9, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Mildred Potter Stull Rn, Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MILDRED POTTER STULL RN, NP (NPI 1215095468) is an individual family provider in Jackson, Georgia, licensed in Georgia (RN043103) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1215095468

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMILDRED POTTER STULLCredential: RN, NP

Location Address1050 MCDONOUGH RDJackson, GA 30233-1524

Mailing Address1050 Mcdonough RdJackson, GA 30233-1524 · (770) 775-7861 · Fax (770) 775-4478

Phone(770) 775-7861

Fax(770) 775-4478

Sole ProprietorNo

Enumeration DateDecember 4, 2006

Last NPPES UpdateJuly 9, 2007

✔ NPI 1215095468 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in GA · RN043103

1050 MCDONOUGH RD, Jackson, GA 30233

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Other Identifiers 1

Medicare ID-Type Unspecified50BBKBSGA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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