Provider Demographics
NPI:1609833607
Name:MITTET, JOANNE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:MITTET
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WAUBUN
Mailing Address - State:MN
Mailing Address - Zip Code:56589
Mailing Address - Country:US
Mailing Address - Phone:218-473-2341
Mailing Address - Fax:
Practice Address - Street 1:40520 CO HWY 34
Practice Address - Street 2:WHITE EARTH HEALTH CENTER
Practice Address - City:OGEMA
Practice Address - State:MN
Practice Address - Zip Code:56569
Practice Address - Country:US
Practice Address - Phone:218-983-4300
Practice Address - Fax:218-983-6217
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1487936163W00000X, 163WG0000X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Not Answered163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care