Provider Demographics
NPI:1538195342
Name:MITCHELL, VELMA DARLENE (CRNP)
Entity type:Individual
Prefix:MS
First Name:VELMA
Middle Name:DARLENE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3756 CRESTBROOK RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35223-1513
Mailing Address - Country:US
Mailing Address - Phone:205-968-3088
Mailing Address - Fax:205-968-3088
Practice Address - Street 1:619 19TH ST S
Practice Address - Street 2:TBNU
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-1900
Practice Address - Country:US
Practice Address - Phone:205-934-1346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL891011670363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL891011670Medicaid
P30127Medicare UPIN
AL891011670Medicaid