Individual
EBONY NICOLE MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6565 FANNIN ST, HOUSTON, TX 77030-2703
(713) 441-5218
Mailing address
3834 MISTISSIN LN, HOUSTON, TX 77053-4553
(346) 754-6230
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
697830
TX
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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