Provider Demographics
NPI:1255763876
Name:MITCHELL, SUSAN MARIE (CNM)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MARIE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:CNM
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Mailing Address - Street 1:1260 CLAREMONT DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-6604
Mailing Address - Country:US
Mailing Address - Phone:303-499-0972
Mailing Address - Fax:
Practice Address - Street 1:1906 BLAKE AVE
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4227
Practice Address - Country:US
Practice Address - Phone:970-945-2238
Practice Address - Fax:970-928-8926
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
COAPN.0990825367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife