Healthcare Provider Details

I. General information

NPI: 1831041466
Provider Name (Legal Business Name): ANNA CAROL MITCHELL CPNP-AC/PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2026
Last Update Date: 02/14/2026
Certification Date: 02/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N STATE ST
JACKSON MS
39216-4500
US

IV. Provider business mailing address

2500 N STATE ST
JACKSON MS
39216-4500
US

V. Phone/Fax

Practice location:
  • Phone: 662-255-2037
  • Fax:
Mailing address:
  • Phone: 662-255-2037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number908131
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: