Provider Demographics
NPI:1720524895
Name:MITCHELL, ANGELA (RD)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MISS
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:SCHEETZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:250 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5137
Mailing Address - Country:US
Mailing Address - Phone:317-274-3432
Mailing Address - Fax:
Practice Address - Street 1:250 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5137
Practice Address - Country:US
Practice Address - Phone:317-274-3432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN923309133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered