Provider Demographics
NPI:1548729262
Name:MITCHELL, JAMES HEATH (FNP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:HEATH
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 N US HIGHWAY 277
Mailing Address - Street 2:
Mailing Address - City:ELDORADO
Mailing Address - State:TX
Mailing Address - Zip Code:76936-4010
Mailing Address - Country:US
Mailing Address - Phone:325-853-2507
Mailing Address - Fax:
Practice Address - Street 1:100 N US HIGHWAY 277
Practice Address - Street 2:
Practice Address - City:ELDORADO
Practice Address - State:TX
Practice Address - Zip Code:76936-4010
Practice Address - Country:US
Practice Address - Phone:325-853-2507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140639363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily