Individual
JOHNNIE LARA MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP-BC, RNFA
Contact information
Practice address
7614 LOCKWOOD RIDGE RD, SARASOTA, FL 34243-4900
(941) 777-5673
Mailing address
12755 157TH ST N, JUPITER, FL 33478-6671
(561) 252-4170
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2831402
FL
163WR0006X
Registered Nurse First Assistant
2831402
FL
363LA2100X
Acute Care Nurse Practitioner
Primary
2831402
FL
Other
Enumeration date
07/31/2006
Last updated
10/07/2024
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