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General NPI Number Information
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NPI Number | 1619955812
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Entity Type | Individual
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Provider Name | JOHN RICHARD MITCHELL RN
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Gender | Male
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 5965 SOUTH 900 EAST STE 240 VALLEY MENTAL HEALTH AD
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City | SALT LAKE CITY
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State | UT
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Zip | 84121-1720
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Country | US
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Telephone | 801-263-7225
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Fax | 801-263-7279
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Provider Business Mailing Address
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Address Line | 8316 VALIANT DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84121-6040
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Country | US
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Telephone | 801-733-5256
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 202824-3102
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License Number State | UT
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