Individual
TERI ANN MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1078348
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02429002
—
MS
05
—
1772402
—
LA
01
—
51515692
BLUE CROSS BLUE SHIELD AL
AL
01
—
P00122086
RR MEDICARE
—
Enumeration date
03/31/2006
Last updated
07/08/2007
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