Individual
COURTNEY RAYNE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
124 GRANDEUR DR, BRANDON, MS 39042-5015
(601) 824-3823
Mailing address
124 GRANDEUR DR, BRANDON, MS 39042-5015
(601) 824-3823
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R852899
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08484019
—
MS
01
—
R852899
CFNP CERTIFICATE NUMBER
MS
Enumeration date
08/20/2006
Last updated
03/01/2016
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