Provider Demographics
NPI:1811061302
Name:MITCHELL, SANDRA ANNE (CRNP, MSCN, AOCN)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:ANNE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:CRNP, MSCN, AOCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 SADDLE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5708
Mailing Address - Country:US
Mailing Address - Phone:301-461-7689
Mailing Address - Fax:301-594-3904
Practice Address - Street 1:NATIONAL INSTITUTES OF HEALTH
Practice Address - Street 2:10 CENTER DRIVE, ROOM 12 S 235 B
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-402-0616
Practice Address - Fax:301-594-3904
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR145894363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR99234Medicare UPIN