Individual
LAVERNE MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, FNP-C
Contact information
Practice address
440 N BONITA AVE STE 10, TUCSON, AZ 85745-2747
(281) 714-8381
Mailing address
18111 OAKFIELD XING, RICHMOND, TX 77407-8544
(281) 714-8381
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
608802
TX
163WH0200X
Home Health Registered Nurse
608802
TX
363LF0000X
Family Nurse Practitioner
AP134923
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
290036
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP134923
TX
Other
Enumeration date
08/03/2017
Last updated
02/08/2024
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