Individual
ASHLEY MARIE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8111 S EMERSON AVE # 101, INDIANAPOLIS, IN 46237-8601
(317) 859-5252
(317) 859-5258
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28214912A
IN
363LF0000X
Family Nurse Practitioner
Primary
71008125A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017570
—
IN
01
—
M47140353
MEDICARE PTAN
IN
Enumeration date
02/11/2018
Last updated
08/03/2023
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