Provider Demographics
NPI:1871365114
Name:MUELLER, CHARLOTTE (PA-C)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:MUELLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7560 BANNOCKBARN DR APT F
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4927
Mailing Address - Country:US
Mailing Address - Phone:847-542-2414
Mailing Address - Fax:
Practice Address - Street 1:7560 BANNOCKBARN DR APT F
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23225-4927
Practice Address - Country:US
Practice Address - Phone:847-542-2414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant