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Individual

JENNIFER LYNN MITCHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
289 S MARKET ST, ELYSBURG, PA 17824-9737
(570) 672-9885
(570) 672-9856
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA061212
PA
363A00000X
Physician Assistant
Primary
OA005872
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103713095
PA
01
894775
MEDICARE
PA
Enumeration date
10/03/2019
Last updated
01/16/2023
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