Provider Demographics
NPI:1134356256
Name:MITCHELL, TRAVIS A (RNFA)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:A
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18001 ROYAL TREE PKWY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-8941
Mailing Address - Country:US
Mailing Address - Phone:239-961-2148
Mailing Address - Fax:239-304-9446
Practice Address - Street 1:18001 ROYAL TREE PKWY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-8941
Practice Address - Country:US
Practice Address - Phone:239-961-2148
Practice Address - Fax:239-304-9446
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9247605163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant