Individual
CHARITY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7120 CLEARVISTA DR, SUITE 2100, INDIANAPOLIS, IN 46256-0020
(317) 621-2740
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28155096A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71005538A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01512404
MEDICARE RR PTAN
IN
Enumeration date
05/20/2015
Last updated
06/03/2024
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