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ROBIN THEO MITCHELL FNP-BC
Acute Care >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1659785582
Individual Registrant: ROBIN THEO MITCHELL FNP-BC
Gender: F
Not Sole Proprietor
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
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: --
Tel: 803-392-1811 Fax: --
Registration Information:
NPI: 1659785582
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Acute Care | SC | 18793 |
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | SC | 18793 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
