Ally Shae Mullins

Physician Assistant · Jackson, MS

Individual Active NPI

NPI number 1114762168

Practice location

2500 N State St
Jackson, MS 39216-4500
Phone
(601) 984-1000

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NPI record

NPI
1114762168
Entity type
Individual (Type 1)
Enumeration date
June 29, 2024
Last updated
March 10, 2025
Certified
February 14, 2025
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X PA00884 MS

Mailing address

110 Hampton Pl
Madison, MS 39110-4575
Phone
(352) 672-5175

About Ally Mullins

Ally Shae Mullins is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 2500 N State St, Jackson, MS 39216-4500. The NPI number 1114762168 was assigned on June 29, 2024 and the record was last updated on March 10, 2025.

Ally Mullins lists a license in the registry: #PA00884 (MS) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Ally Shae Mullins?

The NPI number is 1114762168.

What is the phone number of Ally Mullins?

The phone number listed for the practice location is (601) 984-1000.

Where is Ally Mullins located?

2500 N State St, Jackson, MS 39216-4500.

What is the taxonomy code for Ally Mullins?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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