Provider Demographics
NPI:1942589734
Name:MITCHELL, JUNE (RN)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3665 CLUB DR
Mailing Address - Street 2:STE 107
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1806
Mailing Address - Country:US
Mailing Address - Phone:678-288-6550
Mailing Address - Fax:800-609-0965
Practice Address - Street 1:5524 OLD NATIONAL HWY
Practice Address - Street 2:STE B
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-3212
Practice Address - Country:US
Practice Address - Phone:404-763-8555
Practice Address - Fax:404-763-8502
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN078862163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse