MEDICARE: DEE ANN MITCHELL APRN, BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	129945	NC

General Provider Information

NPI Number	:	1184678849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEE ANN MITCHELL APRN, BC

Provider Business Mailing Address
First Line	:	3111 SPRINGBANK LN
Second Line	:	SUITE G
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3372
Country	:	US
Telephone Number	:	704-965-8045
Fax Number	:	704-540-5866

Provider Business Practice Location Address
First Line	:	3111 SPRINGBANK LN
Second Line	:	SUITE G
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3372
Country	:	US
Telephone Number	:	704-965-8045
Fax Number	:	704-540-5866

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	04/21/2009

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