Healthcare Provider Details

I. General information

NPI: 1609365592
Provider Name (Legal Business Name): BILLIE MITCHELL MS, RN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2018
Last Update Date: 05/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9844 LORI RD STE 102
CHESTERFIELD VA
23832-6691
US

IV. Provider business mailing address

2300 GINTER ST
HENRICO VA
23228-5916
US

V. Phone/Fax

Practice location:
  • Phone: 804-553-9702
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number0015000704
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: