Provider Demographics
NPI:1285801860
Name:MITCHELL LLL, VERNON FULLER (RRT)
Entity type:Individual
Prefix:MR
First Name:VERNON
Middle Name:FULLER
Last Name:MITCHELL LLL
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 JILMAR CT
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-8348
Mailing Address - Country:US
Mailing Address - Phone:828-670-9064
Mailing Address - Fax:
Practice Address - Street 1:1100 TUNNEL ROAD
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805
Practice Address - Country:US
Practice Address - Phone:828-298-7911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRT32132279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care