Provider Demographics
NPI:1396857355
Name:MITCHELL, KATRINE ANN (DPM)
Entity Type:Individual
Prefix:DR
First Name:KATRINE
Middle Name:ANN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10511 GOLF COURSE ROAD NW, SUITE 103
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87048
Mailing Address - Country:US
Mailing Address - Phone:505-232-1140
Mailing Address - Fax:505-232-1132
Practice Address - Street 1:10511 GOLF COURSE ROAD NW, SUITE 103
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87048
Practice Address - Country:US
Practice Address - Phone:505-232-1140
Practice Address - Fax:505-232-1132
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM317213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery