Provider Demographics
NPI:1710862701
Name:MULLINS, TREVOR JOSEPH
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:JOSEPH
Last Name:MULLINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 MATE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MEADOR
Mailing Address - State:WV
Mailing Address - Zip Code:25678-7652
Mailing Address - Country:US
Mailing Address - Phone:304-784-9204
Mailing Address - Fax:
Practice Address - Street 1:1237 MATE CREEK RD
Practice Address - Street 2:
Practice Address - City:MEADOR
Practice Address - State:WV
Practice Address - Zip Code:25678-7652
Practice Address - Country:US
Practice Address - Phone:304-784-9204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant