Provider Demographics
NPI:1528281508
Name:MITCHELL, ANNE MARIE (MS CNM)
Entity type:Individual
Prefix:
First Name:ANNE MARIE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MS CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:571 FRONT ROAD NORTH
Mailing Address - Street 2:
Mailing Address - City:AMHERSTBURG
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N9V 2V6
Mailing Address - Country:CA
Mailing Address - Phone:519-736-0240
Mailing Address - Fax:
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:WP I 354 C
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-8986
Practice Address - Fax:313-916-5008
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704146582367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife