Healthcare Provider Details

I. General information

NPI: 1437117488
Provider Name (Legal Business Name): CATHERINE PELCHAR MITCHELL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 MARGARET ST SUITE 103
PLATTSBURGH NY
12901-1874
US

IV. Provider business mailing address

600 BLAIR PARK RD SUITE 190
WILLISTON VT
05495-7586
US

V. Phone/Fax

Practice location:
  • Phone: 518-562-0151
  • Fax: 518-562-2718
Mailing address:
  • Phone: 802-860-1145
  • Fax: 802-872-0282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number417578-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: