Basic Information
| Provider Information | |||||||||
| NPI: | 1144287327 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MITCHELL | ||||||||
| FirstName: | DAVITA | ||||||||
| MiddleName: | DENISE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RNC, NNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 WEST CLARENDON STE 375 | ||||||||
| Address2: | NEONATOLOGY ASSOCIATES, LTD | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022774161 | ||||||||
| FaxNumber: | 6022663481 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 WEST CLARENDON STE 375 | ||||||||
| Address2: | NEONATOLOGY ASSOCIATES LTD | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022774161 | ||||||||
| FaxNumber: | 6022663481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2006 | ||||||||
| LastUpdateDate: | 11/10/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LN0000X | 2000160944 | MO | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal | 363LN0000X | 45618 | KS | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal | 363LN0000X | 727835 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal | 363LN0000X | APN000966 | NV | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal | 363LN0000X | AP3393 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal |
No ID Information.