Individual
LINDA Y MITCHELL
Active
Individual
LINDA Y MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10000180A
IN
363AS0400X
Surgical Physician Assistant
PA122
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000526795
ANTHEM BCBS
IN
01
—
P00138135
RAILROAD MEDIARE
IN
Enumeration date
06/15/2005
Last updated
11/26/2019
Update your record
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