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Individual

DIANE LOUISE MITCHELL

Active
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Individual

DIANE LOUISE MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

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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