Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | 2000160944 | MO |
N | 363LN0000X | Nurse Practitioner - Neonatal | 45618 | KS |
N | 363LN0000X | Nurse Practitioner - Neonatal | 727835 | TX |
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP3393 | AZ |
N | 363LN0000X | Nurse Practitioner - Neonatal | APN000966 | NV |
NPI | 1144287327 |
---|---|
Provider Name | Mrs. Davita Denise Mitchell |
First Address | Phoenix, AZ 85013 |
Second Address | Phoenix, AZ 85013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2006 |
Last Update Date | 10/11/2009 |