Provider Demographics
NPI:1598485344
Name:MITCHELL, TAYLOR ANN
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10010 BROOKSHORE LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3059
Mailing Address - Country:US
Mailing Address - Phone:281-979-9922
Mailing Address - Fax:
Practice Address - Street 1:4614 NASA PKWY
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:TX
Practice Address - Zip Code:77586-5414
Practice Address - Country:US
Practice Address - Phone:832-864-3785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program