Provider Demographics
NPI:1710117460
Name:MITCHELL, ERIN L (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:L
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:L
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:200 HYGEIA DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:302-733-1439
Mailing Address - Fax:302-733-1888
Practice Address - Street 1:4755 OGLETOWN STANTON RD
Practice Address - Street 2:SUITE 1049 - NEUROVASCULAR ADMINISTRATION
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-0001
Practice Address - Country:US
Practice Address - Phone:302-733-1439
Practice Address - Fax:302-733-1888
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000507363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1710117460Medicaid
DE1710117460Medicaid