Individual
CHANELLE MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1369 E 49TH ST, BROOKLYN, NY 11234-2105
(347) 898-4079
Mailing address
1369 E 49TH ST, BROOKLYN, NY 11234-2105
(347) 898-4079
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
336767-01
NY
Other
Enumeration date
11/01/2019
Last updated
11/01/2019
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