Individual
KELLEY M MITCHELL X
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
210 MILLER STREET, CARRIER MILLS, IL 62917
(618) 713-2270
Mailing address
PO BOX 321, 210 NORTH MILLER STREET, CARRIER MILLS, IL 62917
(618) 713-2270
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043075812
IL
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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