KIMBERLY J MITCHELL (NPI# 1700350170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700350170 |
| Entity Type | Individual |
| Full Name | KIMBERLY J MITCHELL |
| Practice Address |
5 Kennedy Dr Granite City IL 62040 |
| Mailing Address |
5 Kennedy Dr Granite City IL 62040-1851 |
| Practice Telephone | 6185040908 |
| Mailing Telephone | 6185040908 |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2019-01-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.018150 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | . | 209.018150 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356958789 | Kimberly C Mitchell | Home Health Aide | 139 Melrose Ave, Toledo, OH 43610-1527 | 2020-09-29 |
| 1124631601 | Kimberly Mitchell | Pharmacist | 1408 Caddington Ave, Silver Spring, MD 20901-1050 | 2020-08-25 |
| 1538705348 | Kimberly Mitchell | Technician | 5645 Elm Valley Ln, Dallas, TX 75232 | 2019-11-27 |
| 1982172888 | Kimberly Mitchell | Pharmacist | 2181 Old Mountain Rd Ste A, Statesville, NC 28625-1669 | 2018-11-08 |
| 1992213714 | Kimberly Michelle Mitchell | Massage Therapist | 9610 Ashville Dr, Houston, TX 77051-3210 | 2018-01-15 |
| 1023488467 | Kimberly Mitchell | Pharmacist | 5580 Us 25/70 Hwy, Marshall, NC 28753-6499 | 2015-09-28 |
| 1770915514 | Kimberly Dawn Mitchell | Registered Nurse | 11457 69th Pl S, Seattle, WA 98178-3002 | 2013-08-03 |
| 1437438066 | Kimberly A Mitchell | Psychologist | 2600 Garden Rd Ste 122, Monterey, CA 93940-5397 | 2011-08-13 |
| 1649417940 | Kimberly Mitchell | Physical Therapist | 251 E 77th St, Lower Level, New York, NY 10075-2045 | 2009-01-08 |
| 1700060571 | Kimberly Mitchell | Speech-Language Pathologist | 6735 S Oglesby Ave, Chicago, IL 60649-1315 | 2007-12-28 |
| Street Address |
5 KENNEDY DR |
| City | GRANITE CITY |
| State | IL |
| Zip Code | 62040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043736705 | Christine S Bieniecki Canada | Speech-Language Pathologist | 2300 West 25th St, Granite City, IL 62040 | 2017-08-15 |
| 1881085819 | James Watson | Counselor | 50 Northgate Industrial Drive, Granite City, IL 62040 | 2015-02-12 |
| 1518208719 | Chestnut Health Systems | Clinic/Center | 110 Northagte Industrial Drive, Granite City, IL 62040 | 2013-03-13 |
| 1952651697 | Victor Manuel Pinones | Dentist | 2130 Johnson Rd., Granite City, IL 62040 | 2012-09-10 |
| 1427360502 | Erin K Boerm | Occupational Therapist | 3540 Village Lane, Granite City, IL 62040 | 2010-07-06 |
| 1659503027 | Toni Lyn Siler | Counselor | 101 Whitsell Way, Apt 102, Pontoon Beach, IL 62040 | 2009-08-18 |
| 1871741462 | Fountain View Manor LLC | Alzheimer Center (Dementia Center) | 3432 Village Lane, Granite City, IL 62040 | 2008-09-08 |
| 1083880595 | Christina Marie Darin | Chiropractor | 2013 Johnson Road, Suite C & D, Granite City, IL 62040 | 2008-05-05 |
| 1629244322 | Julia Elaine Uhring Green | Counselor | 2429 Washinton Ave, Granite City, IL 62040 | 2008-05-02 |
| 1578786117 | John K Parker | Preventive Medicine | Veeder Health Center, 20th and Iowa, Granite City, IL 62040 | 2007-04-11 |
| Find all providers in zip 62040 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588283360 | Bridget Burwell | Nurse Practitioner | 2100 Madison Ave, Granite City, IL 62040-4713 | 2020-04-13 |
| 1811527120 | Christina Radosevich | Nurse Practitioner | 2861 Madison Ave, Granite City, IL 62040-3614 | 2020-01-25 |
| 1558904508 | Debra J Connell-dent | Nurse Practitioner | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2019-10-22 |
| 1245871243 | Alice M Halliday | Nurse Practitioner | 2861 Madison Ave, Granite City, IL 62040 | 2019-10-01 |
| 1669022182 | Rebecca Lynn Harris | Nurse Practitioner | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2019-09-17 |
| 1366090573 | Donald Lee Clark IIi | Nurse Practitioner | 2100 Madison Ave, Granite City, IL 62040-4713 | 2019-08-30 |
| 1790345726 | Gillian K Long | Nurse Practitioner | 2861 Madison Ave, Granite City, IL 62040-3614 | 2019-06-20 |
| 1750830451 | Brandy Eichelberger | Nurse Practitioner | 2100 Madison Ave, Granite City, IL 62040 | 2016-09-23 |
| 1073973863 | Amanda Hemphill | Nurse Practitioner | 2120 Madison Ave, Suite 404, Granite City, IL 62040-4744 | 2016-03-07 |
| 1578970505 | Joellen Juenger | Nurse Practitioner | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2014-07-22 |
| Find all providers in GRANITE CITY | ||||
| City | GRANITE CITY |
| Zip Code | 62040 |
Please comment or provide details below to improve the information on KIMBERLY J MITCHELL.
| 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.