Provider Demographics
NPI:1407419856
Name:MITCHELL, SHERI NICOLE (NP)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:NICOLE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3853 INDIAN TRL
Mailing Address - Street 2:
Mailing Address - City:CHINA
Mailing Address - State:MI
Mailing Address - Zip Code:48054-2002
Mailing Address - Country:US
Mailing Address - Phone:810-531-9356
Mailing Address - Fax:
Practice Address - Street 1:1385 E 12 MILE RD STE 200
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-2649
Practice Address - Country:US
Practice Address - Phone:248-284-1760
Practice Address - Fax:248-284-1780
Is Sole Proprietor?:No
Enumeration Date:2019-04-20
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704267796363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily