Provider Demographics
NPI:1407887961
Name:MITCHELL, SABRINA LORRAINE (DO)
Entity Type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:LORRAINE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502-0062
Mailing Address - Country:US
Mailing Address - Phone:970-298-2800
Mailing Address - Fax:970-255-6902
Practice Address - Street 1:2698 PATTERSON RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8818
Practice Address - Country:US
Practice Address - Phone:970-298-2800
Practice Address - Fax:970-255-6902
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-1214-03207Q00000X
CO48788207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM15638812Medicaid
UT1407887961Medicaid
CO16029372Medicaid
COCOA100958Medicare PIN
NM348407601Medicare PIN
NM15638812Medicaid
CO16029372Medicaid