Provider Demographics
NPI:1154547511
Name:MITCHELL, VERNESSA M (RN)
Entity type:Individual
Prefix:
First Name:VERNESSA
Middle Name:M
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1686 ROCHESTER ST
Mailing Address - Street 2:2ND FL, PO BOX 508
Mailing Address - City:LIMA
Mailing Address - State:NY
Mailing Address - Zip Code:14485-9717
Mailing Address - Country:US
Mailing Address - Phone:315-719-2454
Mailing Address - Fax:
Practice Address - Street 1:1686 ROCHESTER ST
Practice Address - Street 2:2ND FL
Practice Address - City:LIMA
Practice Address - State:NY
Practice Address - Zip Code:14485-9717
Practice Address - Country:US
Practice Address - Phone:315-719-2454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY550981-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse