Provider Demographics
NPI:1508608084
Name:MITCHELL, ELIZABETH MARIE (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MARIE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5215 TOWNSHIP ROAD 383
Mailing Address - Street 2:
Mailing Address - City:GLENFORD
Mailing Address - State:OH
Mailing Address - Zip Code:43739-9706
Mailing Address - Country:US
Mailing Address - Phone:740-975-5263
Mailing Address - Fax:
Practice Address - Street 1:5215 TOWNSHIP ROAD 383
Practice Address - Street 2:
Practice Address - City:GLENFORD
Practice Address - State:OH
Practice Address - Zip Code:43739-9706
Practice Address - Country:US
Practice Address - Phone:740-975-5263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0035490207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine