Individual
SHASTA NIKITA MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
1875 S REDWOOD RD, SALT LAKE CITY, UT 84104-5112
(435) 764-0156
Mailing address
1481 E PIONEER RD, DRAPER, UT 84020-9623
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
6641648-3102
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6641648-4405
UT
Other
Enumeration date
03/25/2019
Last updated
03/13/2024
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