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NPI Code Detail

MEDICARE: CALLIE MITCHELL APRN-CNP, RN, IMFT-S

MEDICARE: CALLIE MITCHELL APRN-CNP, RN, IMFT-S
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
1106H00000XMarriage & Family TherapistF.1500018OH
2163W00000XRegistered NurseRN.530883OH
3363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN.CNP.0039478OH

General Provider Information

NPI Number : 1376912055
Entity Type Code : Individual
Provider Name (Legal Business Name) : CALLIE MITCHELL APRN-CNP, RN, IMFT-S
Provider Business Mailing Address
First Line : 6265 RIVERSIDE DR STE 2S
Second Line :
City : DUBLIN
State : OH
Zip : 43017-5444
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 59 GRANT ST
Second Line :
City : NEWARK
State : OH
Zip : 43055-3939
Country : US
Telephone Number : 740-349-7511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2015
Last Update Date : 09/10/2025

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