Provider Demographics
NPI:1902158611
Name:MITCHELL, CHRISTOPHER COLTON (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:COLTON
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 W PENINSULAR ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-5213
Mailing Address - Country:US
Mailing Address - Phone:813-731-4913
Mailing Address - Fax:
Practice Address - Street 1:1109 W PENINSULAR ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-5213
Practice Address - Country:US
Practice Address - Phone:813-731-4913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9350232163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice