Provider Demographics
NPI:1669838249
Name:MITCHELL, RACHAEL MELISSA (NNP-BC)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:MELISSA
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3721 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-2714
Mailing Address - Country:US
Mailing Address - Phone:817-991-7363
Mailing Address - Fax:
Practice Address - Street 1:3721 HILLTOP RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-2714
Practice Address - Country:US
Practice Address - Phone:817-991-7363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-12
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130682363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal