| NPI | 1619386455 |
|---|---|
| Former Name | NICHOLE MITCHELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202009378NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 5816) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2023-01-17 |