Individual
LEENA JEMBA MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3614 PROVIDENCE RD S STE 200, WAXHAW, NC 28173-6310
(704) 384-8640
(704) 384-8650
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5010925
NC
Other
Enumeration date
09/10/2018
Last updated
11/15/2022
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