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ROBIN THEO MITCHELL FNP-BC

Acute Care >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1659785582

Individual Registrant:
 ROBIN THEO MITCHELL FNP-BC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
110 SASANQUA DR  GRANITEVILLE, SC 29829 US
Tel: 803-392-1811  Fax: 803-761-6247

Contact information for business:
367 S. GULPH RD ATTN: IPM CREDENTIALING KING OF PRUSSIA, PA 19406-3121 US
Tel: 803-392-1811  Fax: --

Registration Information:
NPI: 1659785582
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363LA2100XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Acute Care
SC18793
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
SC18793

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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