Provider Demographics
NPI:1932284890
Name:MITCHELL, DEBRA (ARNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2637 PALESTA DR
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5158
Mailing Address - Country:US
Mailing Address - Phone:727-372-1055
Mailing Address - Fax:727-725-6817
Practice Address - Street 1:3231 MCMULLEN BOOTH ROAD
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695
Practice Address - Country:US
Practice Address - Phone:727-725-6853
Practice Address - Fax:727-725-6817
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1864142363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal