Individual
DIANE LOUISE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4650 HARVARD CIR, FAIRBANKS, AK 99709
(907) 442-7237
Mailing address
4650 HARVARD CIR, FAIRBANKS, AK 99709-3010
(907) 322-8223
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1365
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1365
AK STATE LICENSE NUMBER
AK
01
—
F0313066
NP CERTIFICATION
AK
Enumeration date
11/04/2013
Last updated
11/04/2013
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