Provider Demographics
NPI:1073394979
Name:MITCHELL, ERICA SHAWNTA (AGACNP- BC)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:SHAWNTA
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:AGACNP- BC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10600 MONTGOMERY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4464
Mailing Address - Country:US
Mailing Address - Phone:513-853-9250
Mailing Address - Fax:513-281-1908
Practice Address - Street 1:10600 MONTGOMERY RD STE 300
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4464
Practice Address - Country:US
Practice Address - Phone:513-853-9250
Practice Address - Fax:513-281-1908
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0034628363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care