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1932923265
CHAQUARRA LASTAYSHA MITCHELL
JACKSONVILLE, TX
NPI
1932923265
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX 1179676)
Enumeration Date
2024-11-13
Last Update Date
2024-11-13
Business Address
CHAQUARRA LASTAYSHA MITCHELL
510 E COMMERCE ST
JACKSONVILLE, TX 75766-4910
Phone number: 903-535-9041
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Mailing Address
CHAQUARRA LASTAYSHA MITCHELL
523 S FANNIN AVE
TYLER, TX 75702-8204
Phone number: 903-535-9041
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