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General NPI Number Information
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NPI Number | 1174473953
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Entity Type | Individual
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Provider Name | CHEYENNE MITCHELL
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Gender | Female
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 02/01/2026
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Provider Practice Location Address
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Address Line | 3705 E MAIN ST
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City | WEATHERFORD
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State | OK
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Zip | 73096-3309
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Country | US
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Telephone | 580-772-2803
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Fax |
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Provider Business Mailing Address
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Address Line | 717 DANA AVE
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City | HINTON
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State | OK
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Zip | 73047-9561
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Country | US
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Telephone | 580-819-1595
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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 | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | E3143289
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 163WF0300X
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Taxonomy Name | Flight Registered Nurse
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License Number | R0121710
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License Number State | OK
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