MEDICARE: MISS RENAE TYLYNNE MITCHELL MSN, APRN, FNP-C

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	363LF0000X	Family Nurse Practitioner	RNP251475	AZ

General Provider Information

NPI Number	:	1205432705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS RENAE TYLYNNE MITCHELL MSN, APRN, FNP-C

Provider Business Mailing Address
First Line	:	1734 E BEAUBIEN DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85024-4372
Country	:	US
Telephone Number	:	480-738-3221
Fax Number	:

Provider Business Practice Location Address
First Line	:	17223 N CAVE CREEK RD UNIT 9
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2481
Country	:	US
Telephone Number	:	480-738-3221
Fax Number	:

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

Provider Enumeration Date	:	12/09/2020
Last Update Date	:	12/20/2023

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