Provider Demographics
NPI:1598052110
Name:MITCHELL, ANDRE SHELDON (APN)
Entity Type:Individual
Prefix:
First Name:ANDRE
Middle Name:SHELDON
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 WINDSONG CIR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5342
Mailing Address - Country:US
Mailing Address - Phone:732-794-1328
Mailing Address - Fax:
Practice Address - Street 1:78 W RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831-1358
Practice Address - Country:US
Practice Address - Phone:609-395-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-03
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00335700363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health