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NPI Code Detail

MEDICARE: LISA ANN MITCHELL NP-C

MEDICARE:   LISA ANN MITCHELL  NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerRN280273GA

General Provider Information

NPI Number : 1275000721
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ANN MITCHELL NP-C
Provider Business Mailing Address
First Line : 221 TECHNOLOGY PKWY NW
Second Line :
City : ROME
State : GA
Zip : 30165-1369
Country : US
Telephone Number : 762-235-1000
Fax Number :
Provider Business Practice Location Address
First Line : 19 REDMOND RD NW
Second Line :
City : ROME
State : GA
Zip : 30165-1533
Country : US
Telephone Number : 762-235-3960
Fax Number : 706-233-8505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2018
Last Update Date : 04/28/2020

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Directions to “ LISA ANN MITCHELL NP-C” Practice Location

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