Provider Demographics
NPI:1821222654
Name:MITCHELL, STEPHANIE LYNN (RN, MSN, CPNP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LYNN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:RN, MSN, CPNP
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Mailing Address - Street 1:PO BOX 99213
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0213
Mailing Address - Country:US
Mailing Address - Phone:682-885-1860
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:801 MATLOCK RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-9174
Practice Address - Country:US
Practice Address - Phone:817-347-8400
Practice Address - Fax:817-347-8495
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2021-05-11
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Provider Licenses
StateLicense IDTaxonomies
TXAP117460363LP0200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics