Healthcare Provider Details

I. General information

NPI: 1063540300
Provider Name (Legal Business Name): JOAN MARIE MITCHELL RN CNOR CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 ESPLANADE
CHICO CA
95926-3310
US

IV. Provider business mailing address

53 CHICORY RD
CHICO CA
95928-9200
US

V. Phone/Fax

Practice location:
  • Phone: 530-332-7300
  • Fax:
Mailing address:
  • Phone: 530-894-2031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number444823
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: