Provider Demographics
NPI:1760869333
Name:MITCHELL, CATHY (RN, MSN, MBA)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:RN, MSN, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 EAST BLF
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-2368
Mailing Address - Country:US
Mailing Address - Phone:608-395-8428
Mailing Address - Fax:
Practice Address - Street 1:344 EAST BLF
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-2368
Practice Address - Country:US
Practice Address - Phone:608-395-8428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-02
Last Update Date:2015-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI182284-30163W00000X
MI4704166918163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse