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General NPI Number Information
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NPI Number | 1073992293
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Entity Type | Individual
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Provider Name | CHARITY MITCHELL
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Gender | Female
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 7120 CLEARVISTA DR SUITE 2100
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-0020
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Country | US
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Telephone | 317-621-2740
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Fax |
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Provider Business Mailing Address
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Address Line | 6626 E 75TH ST SUITE 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2890
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28155096A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 71005538A
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License Number State | IN
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