Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 9769 | NC |
Y | 213EG0000X | General Practice | 9769 | NC |
NPI | 1003229493 |
---|---|
Provider Name | Dr. Kendall Ann Mitchell |
First Address | Goldsboro, NC 27534-2372 |
Second Address | Goldsboro, NC 27534-2372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2014 |
Last Update Date | 17/03/2016 |