MRS. KELLY MITZEN (NPI# 1073584777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073584777 |
| Entity Type | Individual |
| Full Name | MRS. KELLY MITZEN |
| Credential | PA-C |
| Practice Address |
Dilorenzo Tricare Health Clinic Army Pentagon 5801 Washington DC 20310-2802 |
| Practice Telephone | 7036928950 |
| Mailing Telephone | 7036928950 |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2014-03-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0110002992 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI | 1073584777 | 01 |
| Street Address |
DILORENZO TRICARE HEALTH CLINIC ARMY PENTAGON 5801 |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20310-2802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003893470 | Thomas Ostronic | Internal Medicine | Dilorenzo Tricare Health Clinic, 5801 Army Pentagon, Corridor 8, Washington, DC 20310-5801 | 2005-12-28 |
| 1639470107 | Cheryl Annette Clarke | Pharmacist | Dilorenzo Tricare Health Clinic, Mg918b Corridor 8, The Pentagon, Washington, DC 20310-0001 | 2010-11-15 |
| 1386876209 | Colleen A Annes | Preventive Medicine | Dilorenzo Tricare Health Clinic, 5801 Army Pentagon, Washington, DC 20310-0001 | 2009-08-11 |
| 1376707059 | Yu Zheng | Dentist | Dilorenzo Tricare Health Clinic, Washington, DC 20310-3315 | 2008-07-11 |
| 1164646014 | Sharon Michele Henry | Physician Assistant | Dilorenzo Tricare Health Clinic, 5801 Army Pentagon, Washington, DC 20310-0001 | 2007-04-12 |
| 1942272166 | Nancy M. Brown | Physical Therapist | Dilorenzo Tricare Health Clinic, Ciorridor 8, Rm Mg914/918 5801 Army Pentagon, Washington, DC 20310-0001 | 2006-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124668488 | Deborah L Brimmer | Dental Hygienist | 5801 Defense Pentagon, Washington, DC 20310 | 2020-01-14 |
| 1174922645 | Maria Zumer | Physician Assistant | 5801 Army Pentagon, Washington, DC 20310 | 2014-08-20 |
| 1104269398 | Anthony Jason Belotto | Psychiatry & Neurology | 50 Irving Street, Washington, DC 20310 | 2013-04-08 |
| 1639231632 | Wramc | Military/U.S. Coast Guard Pharmacy | 1501 Defense Pentagon, Washington, DC 20310 | 2006-12-15 |
| 1861554867 | Wramc | Military/U.S. Coast Guard Pharmacy | 1501 Defense Pentagon, Washington, DC 20310 | 2006-12-15 |
| 1952463952 | Wramc | Military/U.S. Coast Guard Pharmacy | 1501 Defense Pentagon, Washington, DC 20310 | 2006-12-15 |
| 1538712369 | Genesis Webb | Nurse Practitioner | 50 Irving St Northwest, Washington, DC 20310-0001 | 2019-07-21 |
| 1912359548 | Jessica Lee Nash | Military Health Care Provider | 5811 Army Pentagon # 8, Washington, DC 20310-0001 | 2016-07-07 |
| 1790030898 | Robin C Neal | Dentist | Pentagon Tri Service Dental, 5802 Army Pentagon, Washington, DC 20310-0001 | 2012-07-16 |
| 1720312093 | Jamie Belcastro | Pharmacist | 5801 Defence Pentagon, Washington, DC 20310-0001 | 2009-09-19 |
| Find all providers in zip 20310 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265065619 | Lukas James Williams | Physician Assistant | 110 Irving St Nw Ste 3b-55, Washington, DC 20010-3017 | 2020-02-13 |
| 1841784691 | Amanda-gay A Edwards | Physician Assistant | 3 Washington Cir Nw Ste 305, Washington, DC 20037-2311 | 2018-06-15 |
| 1588177752 | Shelly Powers | Physician Assistant | 6th and Bryant St Nw Annex 1 #116, Washington, DC 20059-0001 | 2017-11-10 |
| 1154832046 | Sarah Elizabeth Walters-slezak | Physician Assistant | 470 Johnson Rd Ste 160, Washington, PA 15301-8968 | 2017-10-18 |
| 1174985220 | Robert Matthew Cronin | Physician Assistant | 3800 Reservoir Rd. Nw, 4phc, Washington, DC 20007 | 2016-03-27 |
| 1639540529 | Jennifer Quyen Tran | Physician Assistant | 332 18th Pl Ne Apt 4, Washington, DC 20002-6650 | 2015-10-17 |
| 1487023511 | Christina Russo | Physician Assistant | 2021 K St Nw Ste 512, Washington, DC 20006-1003 | 2015-09-18 |
| 1194148031 | Luminita Ellis | Physician Assistant | 3700 N Capitol St Nw # 252, Washington, DC 20011-8400 | 2014-01-29 |
| 1518235167 | Anoa Gibson-hunter | Physician Assistant | 4221 Argyle Ter Nw, Washington, DC 20011-4241 | 2011-12-11 |
| 1295014330 | Annise Claude | Physician Assistant | 2021 K St Nw Ste 210, Washington, DC 20006-1003 | 2011-08-08 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 20310 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.