Individual
KATHRYN CORGAN MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1155 E MOUNTAIN BLVD, WILKES BARRE, PA 18702-7906
(570) 808-6113
(570) 808-6349
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA062485
PA
363AM0700X
Medical Physician Assistant
085006150
IL
363AM0700X
Medical Physician Assistant
3760-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922459650
—
WI
Enumeration date
06/23/2016
Last updated
05/10/2022
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