Provider Demographics
NPI:1801964978
Name:MITCHELL, JACKALYN LEE (RN, OGNP)
Entity type:Individual
Prefix:MRS
First Name:JACKALYN
Middle Name:LEE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:RN, OGNP
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Mailing Address - Street 1:612 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-5311
Mailing Address - Country:US
Mailing Address - Phone:910-347-2154
Mailing Address - Fax:910-347-0728
Practice Address - Street 1:612 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-5311
Practice Address - Country:US
Practice Address - Phone:910-347-2154
Practice Address - Fax:910-347-0728
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC764502083P0901X, 363L00000X, 363LA2200X, 363LC1500X, 363LN0000X, 363LW0102X, 363LX0001X, 364SP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Not Answered363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
Not Answered363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Not Answered363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Not Answered364SP1700XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerinatal