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General NPI Number Information
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NPI Number | 1861945164
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Entity Type | Individual
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Provider Name | RENEE L MITCHELL NP
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Gender | Female
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Dates
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Enumeration Date | 08/03/2016
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 612 KINGSBOROUGH SQ STE 100
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City | CHESAPEAKE
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State | VA
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Zip | 23320-5041
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Country | US
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Telephone | 757-547-9342
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Fax | 757-213-9342
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Provider Business Mailing Address
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Address Line | PO BOX 639295 DEPT 93394
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City | CINCINNATI
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State | OH
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Zip | 45263-9295
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Country | US
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Telephone | 248-266-4200
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Fax | 855-618-6655
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024173811
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 0024173811
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License Number State | VA
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