Healthcare Provider Details

I. General information

NPI: 1205743457
Provider Name (Legal Business Name): RASHEEDA MITCHEM APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PARK AVE
MINNEAPOLIS MN
55415-1623
US

IV. Provider business mailing address

1036 KETTLE CREEK RD
EAGAN MN
55123-1517
US

V. Phone/Fax

Practice location:
  • Phone: 612-873-2715
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number2283155
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: