Provider Demographics
NPI:1356649719
Name:MITCHELL, WINIFRED MAUREEN (RN)
Entity Type:Individual
Prefix:
First Name:WINIFRED
Middle Name:MAUREEN
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 1:14785 FORD RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057-9528
Mailing Address - Country:US
Mailing Address - Phone:215-499-9586
Mailing Address - Fax:
Practice Address - Street 1:14785 FORD RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-9528
Practice Address - Country:US
Practice Address - Phone:215-499-9586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN604064163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse