Individual
KIMBERLY J MITCHELL
Active
Individual
KIMBERLY J MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209018150
IL
363LF0000X
Family Nurse Practitioner
Primary
209.018150
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019026962
STATE LICENSE MO
MO
01
—
209.018150
.
IL
Enumeration date
01/18/2019
Last updated
06/06/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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