Provider Demographics
NPI:1497465355
Name:MITCHELL, ANGELA MARIA (RN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIA
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 1:1957 MINIMALIST LN
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-3210
Mailing Address - Country:US
Mailing Address - Phone:810-513-8581
Mailing Address - Fax:
Practice Address - Street 1:1957 MINIMALIST LN
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-3210
Practice Address - Country:US
Practice Address - Phone:810-513-8581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95207982163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95207982OtherREGISTERED NURSE LICENSE