MEDICARE: MICHAEL CHRISTOPHER 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
1	363LF0000X	Family Nurse Practitioner	AP128684	TX

General Provider Information

NPI Number	:	1942686035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL CHRISTOPHER MITCHELL NP

Provider Business Mailing Address
First Line	:	1039 N TWIN CITY HWY STE B
Second Line	:
City	:	NEDERLAND
State	:	TX
Zip	:	77627-3851
Country	:	US
Telephone Number	:	409-722-0026
Fax Number	:	409-729-2783

Provider Business Practice Location Address
First Line	:	1039 N TWIN CITY HWY STE B
Second Line	:
City	:	NEDERLAND
State	:	TX
Zip	:	77627-3851
Country	:	US
Telephone Number	:	409-722-0026
Fax Number	:	409-729-2783

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

Provider Enumeration Date	:	07/31/2015
Last Update Date	:	02/09/2024

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