Individual
REGINA MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N
Contact information
Practice address
5853 BREWBAKER BLVD, MONTGOMERY, AL 36116-4259
(334) 316-5080
Mailing address
5853 BREWBAKER BLVD, MONTGOMERY, AL 36116-4259
(334) 316-5080
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-054230
AL
164W00000X
Licensed Practical Nurse
201707302
OR
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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