Healthcare Provider Details
I. General information
NPI: 1558024794
Provider Name (Legal Business Name): SIMONE MITCHELL CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/14/2021
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1840 AMHERST ST
WINCHESTER VA
22601-2808
US
IV. Provider business mailing address
1419 GATEWOOD PL
AUBURN AL
36830-2977
US
V. Phone/Fax
- Phone: 540-536-8000
- Fax:
- Phone: 317-937-7670
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | 3016869 |
| License Number State | KY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | APRN11025475 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 176B00000X |
| Taxonomy | Midwife |
| License Number | 0024187662 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: