Provider Demographics
NPI:1861431660
Name:MITCHELL, CARLON J (RN, APRN-BC)
Entity type:Individual
Prefix:MRS
First Name:CARLON
Middle Name:J
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:RN, APRN-BC
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Mailing Address - Street 1:1905 IVY HALL RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-3523
Mailing Address - Country:US
Mailing Address - Phone:843-571-6457
Mailing Address - Fax:843-746-3814
Practice Address - Street 1:4050 BRIDGE VIEW DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-8415
Practice Address - Country:US
Practice Address - Phone:843-746-3808
Practice Address - Fax:843-746-3814
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCP 409363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health