| Doctor Name: | MS. KELLY D. MITCHELL |
| NPI Number: | 1114203130 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SRNA |
| License Number: | R40164 |
| Business Practice Address: | 3333 Springhill Dr North Little Rock, AR - 721172922 |
| Business Phone Number: | 5012023000 |
| Business Fax Number: | |
| Mailing Address: | 8300 E Cherry St, BENTON |
| State: | AR |
| Postal Code: | 720158806 |
| Phone Number: | 5013105461 |
| Fax Number: | |
| NPI Enumeration Date: | 10/24/2011 |
| NPI Last Update Date: | 10/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | R40164 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |