Provider Demographics
NPI:1962267971
Name:MITCHELL, PAULLA GAYLE (CD)
Entity type:Individual
Prefix:MISS
First Name:PAULLA
Middle Name:GAYLE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 ASHBY RD
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-4014
Mailing Address - Country:US
Mailing Address - Phone:334-820-7050
Mailing Address - Fax:
Practice Address - Street 1:214 ASHBY RD
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-4014
Practice Address - Country:US
Practice Address - Phone:334-820-7050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6830374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty