Individual
AMY BETH MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2605 SW WHITE BIRCH DRIVE, ANKENY, IA 50023-7235
(515) 643-7100
(515) 643-7145
Mailing address
PO BOX 1475, DES MOINES, IA 50305-1475
(515) 643-7100
(515) 643-7145
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3641
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14651957
—
IA
05
—
3465195
—
IA
01
—
49226
WELLMARK BLUE SHIELD
IA
Enumeration date
11/22/2005
Last updated
01/12/2012
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