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General NPI Number Information
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NPI Number | 1831035385
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Entity Type | Individual
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Provider Name | ALLYSON GRACE MITCHELL PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 4805 S MOORLAND RD
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City | NEW BERLIN
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State | WI
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Zip | 53151-7401
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Country | US
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Telephone | 262-798-7200
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Fax | 262-798-7201
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Provider Business Mailing Address
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Address Line | 6381 209TH ST N
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City | FOREST LAKE
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State | MN
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Zip | 55025-8063
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | WI
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