Individual
MARY KAY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1033 E WASHINGTON ST, INDIANAPOLIS, IN 46202-3952
(317) 423-8909
Mailing address
PO BOX 637764, CINCINNATI, OH 45263-7764
(317) 880-3939
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001842A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000498605
ANTHEM
IN
05
—
200511150
—
IN
Enumeration date
05/25/2006
Last updated
09/25/2025
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