Doctor Name: | MRS. SHERRY DIANN MITCHELL |
NPI Number: | 1043466014 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN-CNP |
License Number: | R0080778 |
Business Practice Address: | 309 W. 2nd St. Wellston, OK - 74881 |
Business Phone Number: | 4053562998 |
Business Fax Number: | 4053569937 |
Mailing Address: | Po Box 98, WELLSTON |
State: | OK |
Postal Code: | 748810098 |
Phone Number: | 4053562998 |
Fax Number: | 4053569937 |
NPI Enumeration Date: | 08/11/2008 |
NPI Last Update Date: | 11/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R0080778 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |