Individual
STEPHANIE MARIE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 856-5599
(508) 334-7284
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2341767
MA
363LA2100X
Acute Care Nurse Practitioner
RN2341767
MA
Other
Enumeration date
04/13/2020
Last updated
11/05/2020
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