Individual
MISS CONSTANCE MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN781915
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
95009958
CA
Other
Enumeration date
07/24/2012
Last updated
10/22/2024
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