Provider Demographics
NPI:1184678849
Name:MITCHELL, DEE ANN (APRN, BC)
Entity Type:Individual
Prefix:
First Name:DEE
Middle Name:ANN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 SPRINGBANK LN
Mailing Address - Street 2:SUITE G
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3372
Mailing Address - Country:US
Mailing Address - Phone:704-965-8045
Mailing Address - Fax:704-540-5866
Practice Address - Street 1:3111 SPRINGBANK LN
Practice Address - Street 2:SUITE G
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3372
Practice Address - Country:US
Practice Address - Phone:704-965-8045
Practice Address - Fax:704-540-5866
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC129945163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2608448Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE #