Mitchell, Kimberly J

Mitchell, Kimberly J is an individual health care provider with primary practice located at 2420 State St , East Saint Louis IL 62205-2321. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Mitchell, Kimberly J can be contacted via phone (618) 318-8809.

Contact Information

Primary practice address
2420 State St East Saint Louis IL 62205-2321
Phone: (618) 318-8809
Fax: (618) 615-4205
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209018150 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209.018150 Illinois

Profile Details

NPI number 1700350170
LBN Legal business name Mitchell, Kimberly J
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2019
Last updated Feb 23rd, 2024 - about last year

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 1700350170 NPPES
Missouri Other 2019026962 STATE LICENSE MO
Missouri Other 209.018150 STATE LICENSE MO

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