Individual
MS. NIKKI JO MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, PMHNP-BC
Contact information
Practice address
4488 ROSLIN RD, NEWBURGH, IN 47630-8590
(812) 996-5616
Mailing address
6544 RIVER RIDGE DR, NEWBURGH, IN 47630-9778
(812) 660-0708
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71002315A
IN
363LF0000X
Family Nurse Practitioner
71002315A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71002315
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000654612
BCBS #
KY
05
—
200845810
—
IN
05
—
7100104280
—
KY
Enumeration date
11/01/2006
Last updated
05/10/2023
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