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NPI Code Detail

MEDICARE: SHANNON NICOLE MITCHELL FNP-BC

MEDICARE: SHANNON NICOLE MITCHELL FNP-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
1363LF0000XFamily Nurse Practitioner2021182704OH

General Provider Information

NPI Number : 1821581273
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON NICOLE MITCHELL FNP-BC
Provider Business Mailing Address
First Line : 295 PARK DR
Second Line :
City : CAMPBELL
State : OH
Zip : 44405-1259
Country : US
Telephone Number : 330-951-5058
Fax Number :
Provider Business Practice Location Address
First Line : 3551 BELMONT AVE STE 19B
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44505-1439
Country : US
Telephone Number : 330-222-4030
Fax Number : 330-230-7498
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2018
Last Update Date : 02/25/2026

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