Provider Demographics
NPI:1538357009
Name:MITCHELL, BABEE ANGELYNNE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:BABEE
Middle Name:ANGELYNNE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 W EVERGREEN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-6984
Mailing Address - Country:US
Mailing Address - Phone:907-746-3366
Mailing Address - Fax:907-746-3368
Practice Address - Street 1:440 W EVERGREEN AVE STE A
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-6984
Practice Address - Country:US
Practice Address - Phone:907-746-3366
Practice Address - Fax:907-746-3368
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK821363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMDA0020Medicaid