MEDICARE: MRS. SHERI J MITCHELL FNP

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	17773	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	17773	OTHER	CA	BOARD OF REG NURSING

General Provider Information

NPI Number	:	1326236340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHERI J MITCHELL FNP

Provider Business Mailing Address
First Line	:	34490 BOB HOPE DR.
Second Line	:
City	:	RANCHO MIRAGE
State	:	CA
Zip	:	92270-0000
Country	:	US
Telephone Number	:	760-568-3613
Fax Number	:	760-340-5189

Provider Business Practice Location Address
First Line	:	34490 BOB HOPE DR.
Second Line	:
City	:	RANCHO MIRAGE
State	:	CA
Zip	:	92270-0000
Country	:	US
Telephone Number	:	760-568-3613
Fax Number	:	760-340-5189

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

Provider Enumeration Date	:	10/04/2007
Last Update Date	:	05/26/2020

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