Individual
SHAYQUELL MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
314 LOGGERHEAD DR, COLUMBIA, SC 29229-7904
(803) 760-5554
Mailing address
615 KINGS RD, ORANGEBURG, SC 29115-3861
(803) 378-7062
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
258517
SC
Other
Enumeration date
01/28/2017
Last updated
06/01/2025
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