Organization
PSYCHIATRIC NP SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN SAPP MITCHELL NP (NURSE PRACTITIONER)
(478) 284-1116
Entity
Organization
Contact information
Practice address
5228 BRANDYWINE DR, MACON, GA 31210-2902
(478) 284-1116
Mailing address
5228 BRANDYWINE DR, MACON, GA 31210-2902
(478) 284-1116
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN063812
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008002521
ADVANCED PRACTICE ANCC CERTIFICATION
GA
01
—
RN063812
LICENSE NUMBER
GA
Enumeration date
09/26/2014
Last updated
09/26/2014
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