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General NPI Number Information
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NPI Number | 1164342416
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Entity Type | Individual
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Provider Name | ADAM JAMES MITCHELL
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Gender | Male
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Dates
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Enumeration Date | 07/17/2026
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Last Update Date | 07/17/2026
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Provider Practice Location Address
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Address Line | 4005 RIPA AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63125-2378
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Country | US
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Telephone | 314-544-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 2212 HICKORY ST
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City | SAINT LOUIS
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State | MO
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Zip | 63104-2417
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Country | US
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Telephone | 573-837-0601
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 2026034005
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License Number State | MO
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