Healthcare Provider Details

I. General information

NPI: 1932956141
Provider Name (Legal Business Name): KRISTEN MITCHEM APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6024 SPIKES WAY
MILTON FL
32583-2827
US

IV. Provider business mailing address

1221 W LAKEVIEW AVE
PENSACOLA FL
32501-1836
US

V. Phone/Fax

Practice location:
  • Phone: 850-469-3500
  • Fax: 850-595-1400
Mailing address:
  • Phone: 850-469-3500
  • Fax: 850-595-1400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11031667
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: