Individual
MRS. KATHLEEN MCCOMBS MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2277
SC
363AS0400X
Surgical Physician Assistant
Primary
2277
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2162PA
—
SC
01
—
SC56835019
MEDICARE PIN
SC
01
—
SC56836067
MEDICARE PIN
SC
01
—
SC56836084
MEDICARE PIN
SC
01
—
SC5683J577
MEDICARE PIN
SC
Enumeration date
04/27/2015
Last updated
07/15/2026
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