Provider Demographics
NPI:1588642391
Name:MITCHELL, PATRICIA H (NP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:H
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8494 S SCENIC HWY STE CD
Mailing Address - Street 2:
Mailing Address - City:BLAND
Mailing Address - State:VA
Mailing Address - Zip Code:24315-5255
Mailing Address - Country:US
Mailing Address - Phone:276-688-0500
Mailing Address - Fax:276-688-3200
Practice Address - Street 1:8494 S SCENIC HWY STE CD
Practice Address - Street 2:
Practice Address - City:BLAND
Practice Address - State:VA
Practice Address - Zip Code:24315-5255
Practice Address - Country:US
Practice Address - Phone:276-688-0500
Practice Address - Fax:276-688-3200
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024075081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA27-2519663Medicaid
VA27-2519663Medicare PIN
VA272519663Medicare Oscar/Certification
VA27-2519663Medicaid