Individual
ANGELA R MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
509 MEMORIAL DR STE 2, MANCHESTER, KY 40962-6196
(606) 598-4538
(606) 599-2528
Mailing address
509 MEMORIAL DR STE 2, MANCHESTER, KY 40962-6196
(606) 598-5104
(606) 598-0983
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3003819
KY
363LF0000X
Family Nurse Practitioner
3819P
KY
363LF0000X
Family Nurse Practitioner
5004210
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11386486
CAQH ID
—
05
—
7004259
—
NC
05
—
78008133
—
KY
05
—
NP1343
—
SC
Enumeration date
01/23/2006
Last updated
03/07/2023
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