Individual
KELLY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1853 RW BERENDS DR SW, WYOMING, MI 49519-4955
(616) 534-9300
Mailing address
639 SUNSET HLS, MIDDLEVILLE, MI 49333-8280
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704308048
MI
Other
Enumeration date
05/20/2018
Last updated
05/20/2018
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