Individual
KEITHA HALLMARK MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
600 SUN TEMPLE DR, MADISON, AL 35758-8643
(256) 975-4291
(256) 325-1890
Mailing address
600 SUN TEMPLE DR, MADISON, AL 35758-8643
(256) 975-4291
(256) 325-1890
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-151423
AL
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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