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NPI Code Detail

MEDICARE: STEPHANIE S MITCHELL NP

MEDICARE: STEPHANIE S MITCHELL NP
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
1363L00000XNurse Practitioner196436MA
2363LP0200XPediatric Nurse Practitioner196436MA
3363L00000XNurse PractitionerRN196436MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2NP9695OTHERMABLUE CROSS
3PC213OTHERMAHARVARD PILGRIM

General Provider Information

NPI Number : 1568439370
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE S MITCHELL NP
Provider Business Mailing Address
First Line : 874 PURCHASE ST
Second Line :
City : NEW BEDFORD
State : MA
Zip : 02740-6232
Country : US
Telephone Number : 508-992-6553
Fax Number : 508-984-8420
Provider Business Practice Location Address
First Line : 874 PURCHASE ST
Second Line :
City : NEW BEDFORD
State : MA
Zip : 02740-6232
Country : US
Telephone Number : 508-992-6553
Fax Number : 508-984-8420
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2006
Last Update Date : 04/20/2018

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