Provider Demographics
NPI: | 1265108005 |
---|---|
Name: | MITCHELL, PHALINA (RN) |
Entity type: | Individual |
Prefix: | |
First Name: | PHALINA |
Middle Name: | |
Last Name: | MITCHELL |
Suffix: | |
Gender: | F |
Credentials: | RN |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 6813 S 43RD DR |
Mailing Address - Street 2: | |
Mailing Address - City: | LAVEEN |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85339-6245 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 602-502-6238 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 6813 S 43RD DR |
Practice Address - Street 2: | |
Practice Address - City: | LAVEEN |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85339-6245 |
Practice Address - Country: | US |
Practice Address - Phone: | 602-502-6238 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2021-08-20 |
Last Update Date: | 2021-08-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 835945 | 163WA2000X, 163WC0400X, 163WC1500X, 163WC1600X, 163WC2100X, 163WD0400X, 163WH0200X, 163WI0500X, 163WI0600X, 163WM0102X, 163WN1003X, 163WP0000X, 163WP0808X, 163WX1500X, 163W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 163W00000X | Nursing Service Providers | Registered Nurse | |
No | 163WA2000X | Nursing Service Providers | Registered Nurse | Administrator |
No | 163WC0400X | Nursing Service Providers | Registered Nurse | Case Management |
No | 163WC1500X | Nursing Service Providers | Registered Nurse | Community Health |
No | 163WC1600X | Nursing Service Providers | Registered Nurse | Continuing Education/Staff Development |
No | 163WC2100X | Nursing Service Providers | Registered Nurse | Continence Care |
No | 163WD0400X | Nursing Service Providers | Registered Nurse | Diabetes Educator |
No | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health |
No | 163WI0500X | Nursing Service Providers | Registered Nurse | Infusion Therapy |
No | 163WI0600X | Nursing Service Providers | Registered Nurse | Infection Control |
No | 163WM0102X | Nursing Service Providers | Registered Nurse | Maternal Newborn |
No | 163WN1003X | Nursing Service Providers | Registered Nurse | Nutrition Support |
No | 163WP0000X | Nursing Service Providers | Registered Nurse | Pain Management |
No | 163WP0808X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health |
No | 163WX1500X | Nursing Service Providers | Registered Nurse | Ostomy Care |