Individual
DONNA JEAN MITCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
834 CHESTNUT ST, PHILADELPHIA, PA 19107-5127
(215) 955-4367
Mailing address
9 CHERRY GROVE LN, SICKLERVILLE, NJ 08081-3061
(856) 875-2755
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
26NJ00332900
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
SP011475
PA
Other
Enumeration date
08/03/2011
Last updated
08/03/2011
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