Provider Demographics
NPI:1083324578
Name:MITCHELL, FLORY H (RN)
Entity Type:Individual
Prefix:
First Name:FLORY
Middle Name:H
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2141 CHENANGO RD S
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:44851-9538
Mailing Address - Country:US
Mailing Address - Phone:419-921-6261
Mailing Address - Fax:
Practice Address - Street 1:3 STOWER LN STE 2
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2612
Practice Address - Country:US
Practice Address - Phone:419-951-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-25
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH398841163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse