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NPI Code Detail

MEDICARE: AMY LACHELLE MITCHELL FNP-BC

MEDICARE: AMY LACHELLE MITCHELL FNP-BC
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
1363LF0000XFamily Nurse PractitionerAP141232TX

General Provider Information

NPI Number : 1407485345
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY LACHELLE MITCHELL FNP-BC
Provider Business Mailing Address
First Line : 580 S DENTON TAP RD STE 123
Second Line :
City : COPPELL
State : TX
Zip : 75019-4099
Country : US
Telephone Number : 972-462-0762
Fax Number :
Provider Business Practice Location Address
First Line : 601 S MAIN ST STE 200
Second Line :
City : KELLER
State : TX
Zip : 76248-7028
Country : US
Telephone Number : 682-549-3311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2020
Last Update Date : 03/10/2026

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