Healthcare Provider Details

I. General information

NPI: 1871302646
Provider Name (Legal Business Name): MICHELLE MITCHELL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MOFFAT AVE
HOT SULPHUR SPRINGS CO
80451-5058
US

IV. Provider business mailing address

PO BOX 264
HOT SULPHUR SPRINGS CO
80451-0264
US

V. Phone/Fax

Practice location:
  • Phone: 970-531-3423
  • Fax:
Mailing address:
  • Phone: 970-531-3423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0083703
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: