Doctor Name: | MRS. JUANITA LYNN MITCHELL |
NPI Number: | 1356557466 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 222078-2-AFC |
Business Practice Address: | 508 3rd Ave Hewitt, MN - 564530015 |
Business Phone Number: | 2189244179 |
Business Fax Number: | |
Mailing Address: | 508 3rd Ave P.o.box 15, HEWITT |
State: | MN |
Postal Code: | 564530015 |
Phone Number: | 2189244179 |
Fax Number: | |
NPI Enumeration Date: | 05/15/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 177F00000X |
License Number: | 222078-2-AFC |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Lodging |
Taxonomy Specialization: | |
Taxonomy Definition: | A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home. |