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General NPI Number Information
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NPI Number | 1376037374
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Entity Type | Individual
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Provider Name | SHANNON M MITCHELL APRN
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Gender | Female
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 15300 S JOG RD STE 203
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City | DELRAY BEACH
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State | FL
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Zip | 33446-2166
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Country | US
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Telephone | 561-289-4642
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Fax | 561-257-1154
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Provider Business Mailing Address
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Address Line | 125 S STATE ROAD 7 SUITE 104-342
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City | WELLINGTON
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State | FL
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Zip | 33414
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Country | US
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Telephone | 561-289-4642
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Fax | 561-257-1154
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN9228410
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License Number State | FL
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