Provider Demographics
NPI:1366803181
Name:MITCHELL, KATHERINE (CNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19580 SCOUT LN
Mailing Address - Street 2:
Mailing Address - City:SAINT ONGE
Mailing Address - State:SD
Mailing Address - Zip Code:57779-7913
Mailing Address - Country:US
Mailing Address - Phone:605-491-2832
Mailing Address - Fax:605-988-6648
Practice Address - Street 1:1800 S DOROTHY AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-3826
Practice Address - Country:US
Practice Address - Phone:701-516-4637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-08
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP001058363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily