Provider Demographics
NPI:1235591264
Name:MITCHELL-THOMAS, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MITCHELL-THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 221
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4336 NORTH BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:BATON ROUGR
Practice Address - State:LA
Practice Address - Zip Code:70592
Practice Address - Country:US
Practice Address - Phone:337-451-7154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA087224163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse