Individual
TRACIE MICHELLE MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1004 SOUTH ST E, TALLADEGA, AL 35160-2621
(256) 493-6402
Mailing address
1004 SOUTH ST E, STE A, TALLADEGA, AL 35160-2621
(256) 362-2013
(256) 362-2015
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
1-072535
AL
261QR1300X
Rural Health Clinic/Center
1-072535
AL
363LF0000X
Family Nurse Practitioner
Primary
1-072535
AL
Other
Enumeration date
12/19/2018
Last updated
03/04/2020
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