Individual
REBECCA LEE MITCHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-C, RN
Contact information
Practice address
3800 S W S YOUNG DR STE 201, KILLEEN, TX 76542-3340
(254) 245-9175
Mailing address
PO BOX 11538, KILLEEN, TX 76547-1538
(254) 245-9175
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1173843
TX
363L00000X
Nurse Practitioner
219787
OK
363L00000X
Nurse Practitioner
244088
MT
Other
Enumeration date
08/19/2024
Last updated
11/05/2025
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