Individual
JILL M MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9201
(262) 329-1000
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2131
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6289
WI
363LF0000X
Family Nurse Practitioner
6289-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164819033
—
WI
Enumeration date
04/18/2015
Last updated
11/23/2021
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