Individual
LAURAE N. MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1536 E PRIMROSE ST, SPRINGFIELD, MO 65804-7928
(417) 882-1818
Mailing address
1536 E PRIMROSE ST, SPRINGFIELD, MO 65804-7928
(417) 882-1818
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063759223
—
MO
Enumeration date
01/08/2013
Last updated
07/21/2022
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