Provider Demographics
NPI:1326197369
Name:MITCHELL-MCLAREN, JOANNE ELAINE (NP)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:ELAINE
Last Name:MITCHELL-MCLAREN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ENGLEWOOD HL
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-2554
Mailing Address - Country:US
Mailing Address - Phone:585-334-7854
Mailing Address - Fax:
Practice Address - Street 1:80 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14604-1310
Practice Address - Country:US
Practice Address - Phone:585-454-7530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380680363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics