Individual
MRS. JERILYN J. MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS, LP (PMHCNS-BC,
Contact information
Practice address
712 SOUTH CASCADE STREET, FERGUS FALLS, MN 56537-2813
(218) 736-8000
(218) 736-8757
Mailing address
712 SOUTH CASCADE STREET, FERGUS FALLS, MN 56537-2813
(218) 736-8000
(218) 736-8757
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
LP2805
MN
364S00000X
Clinical Nurse Specialist
R054697-5
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
087-058700
—
MN
01
—
5457131-01
MA PROVIDER FOR CNS, LP
MN
Enumeration date
10/04/2006
Last updated
07/08/2010
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