Provider Demographics
NPI:1194691766
Name:JOHNSON MITCHELL, JODI ELAINE (BSN-RN)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:ELAINE
Last Name:JOHNSON MITCHELL
Suffix:
Gender:F
Credentials:BSN-RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 GULFWOOD RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-2282
Mailing Address - Country:US
Mailing Address - Phone:865-978-7929
Mailing Address - Fax:
Practice Address - Street 1:333 AXTON DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2555
Practice Address - Country:US
Practice Address - Phone:865-978-7929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-13
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
TN181198163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171400000XOther Service ProvidersHealth & Wellness Coach