Individual
KELLY MARIE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1012 W VILLAS DR, VICKSBURG, MI 49097-9626
(586) 337-7343
Mailing address
1012 W VILLAS DR, VICKSBURG, MI 49097-9626
(586) 337-7343
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704273546
MI
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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