Provider Demographics
NPI:1215124383
Name:MITCHELL, KATHY L (RN, DEM)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:L
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:RN, DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 CEDAR CIR
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:OH
Mailing Address - Zip Code:43056-1719
Mailing Address - Country:US
Mailing Address - Phone:740-323-1006
Mailing Address - Fax:740-323-4355
Practice Address - Street 1:1816 CEDAR CIR
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:OH
Practice Address - Zip Code:43056-1719
Practice Address - Country:US
Practice Address - Phone:740-323-1006
Practice Address - Fax:740-323-4355
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife