Provider Demographics
NPI:1033558176
Name:MITCHELL, TREVA GREEN (MSN, RN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:TREVA
Middle Name:GREEN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MSN, RN, FNP
Other - Prefix:MISS
Other - First Name:TREVA
Other - Middle Name:RENEE
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24048 KUYKENDAHL RD
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-5326
Mailing Address - Country:US
Mailing Address - Phone:281-255-3897
Mailing Address - Fax:
Practice Address - Street 1:24048 KUYKENDAHL RD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-5326
Practice Address - Country:US
Practice Address - Phone:281-255-3897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX714292363LF0000X
TXAP124001363LF0000X
TX124001363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily