Individual
MRS. COURTNEY COMELLA MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2351 HUGUENARD DRIVE, SUITE 200, LEXINGTON, KY 40503
(859) 276-0191
(859) 277-0466
Mailing address
2351 HUGUENARD DRIVE, SUITE 200, LEXINGTON, KY 40503
(859) 276-0191
(859) 277-0466
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA923
KY
363AM0700X
Medical Physician Assistant
Primary
PA923
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4000501
MEDICARE LAB GROUP
KY
Enumeration date
10/20/2005
Last updated
11/02/2007
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