Provider Demographics
NPI:1508846346
Name:MITCHELL, KAREN-MAE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN-MAE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3816 S CLEAR CREEK RD STE E
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-4401
Mailing Address - Country:US
Mailing Address - Phone:254-554-8773
Mailing Address - Fax:
Practice Address - Street 1:3816 S CLEAR CREEK RD STE E
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4401
Practice Address - Country:US
Practice Address - Phone:254-554-8773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN09902083P0901X
NC2002000259207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH76295Medicare UPIN