Individual
OPAL MAHALIA MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
830 HARRISON AVENUE, STE 1400, BOSTON, MA 02118
(617) 638-8124
(617) 414-4953
Mailing address
960 MASSACHUSETTS AVENUE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN283932
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110155285A
—
MA
05
—
1346218294
—
MA
05
—
3138582
—
NH
Enumeration date
05/08/2019
Last updated
09/09/2025
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