Individual
SHANNON LARIE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN-ACNP
Contact information
Practice address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Mailing address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
653277
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP115188
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
653277
RN
TX
01
—
AP115188
APRN
TX
Enumeration date
08/21/2007
Last updated
08/03/2015
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