Individual
SHONTA TAYLOR MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
425 N SALEM AVE, SUMTER, SC 29150-4115
(803) 774-4541
Mailing address
2135 INDIANGRASS CV, SUMTER, SC 29153-8411
(803) 394-4257
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
30239
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NN1274
—
SC
Enumeration date
05/02/2025
Last updated
07/30/2025
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