Mitchell, Holly Wilson

Mitchell, Holly Wilson is an individual health care provider with primary practice located at 220 J L White Dr Ste 120 , Jasper GA 30143-4894. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Women's Health Care, Ambulatory, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Mitchell, Holly Wilson can be contacted via phone (706) 692-3539.

Contact Information

Primary practice address
220 J L White Dr Ste 120 Jasper GA 30143-4894
Phone: (706) 692-3539
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Women's Health Care, Ambulatory 163WW0101X RN162066 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X RN162066 Georgia

Profile Details

NPI number 1225468028
LBN Legal business name Mitchell, Holly Wilson
Credentials RN, CNM
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2013
Last updated Sep 14th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225468028 NPPES
Georgia MEDICAID 003143552C
Georgia MEDICAID 003143552D
Georgia MEDICAID 003143552A
Georgia MEDICAID 003143552B

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