Provider Demographics
NPI:1770628547
Name:MITCHELL, FELICIA GAIL (RN)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:GAIL
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 HWY 51 SOUTH
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38063
Mailing Address - Country:US
Mailing Address - Phone:731-635-5131
Mailing Address - Fax:731-635-3630
Practice Address - Street 1:500 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-4583
Practice Address - Country:US
Practice Address - Phone:731-635-5131
Practice Address - Fax:731-635-3630
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000032495163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse