Individual
JAIME MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
509 W UNIVERSITY AVE, URBANA, IL 61801-1645
(217) 383-6636
(217) 383-3466
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801-2529
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209011507
IL
Other
Enumeration date
05/06/2014
Last updated
04/13/2021
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