MARYLYN MITCHELL (NPI# 1730707860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730707860 |
| Entity Type | Individual |
| Full Name | MARYLYN MITCHELL |
| Credential | AGACNP-BC |
| Practice Address |
2120 Broken Shoe Trl Temple TX 76502-0085 |
| Practice Telephone | 2542286062 |
| Mailing Telephone | 2542286062 |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2020-07-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
1000062 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TEXAS NP LICENSE NUMBER | 1000062 | 01 |
| Street Address |
2120 BROKEN SHOE TRL |
| City | TEMPLE |
| State | TX |
| Zip Code | 76502-0085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710850 | Bih Mobanoe Chi | Pharmacist | 6801 West Adams Avenue, Temple, TX 76502 | 2020-11-06 |
| 1639705403 | Robert David Pompella | Chiropractor | 4805 Stone Ridge Dr, Temple, TX 76502 | 2020-03-12 |
| 1275167488 | Luong Dental, LLC | Dentist | 5297 S. 31st Street, Ste 111, Temple, TX 76502 | 2020-02-26 |
| 1093357931 | Ryan T Stephens Dmd Pllc | Dentist | 5408 W. Adams Suite 102, Temple, TX 76502 | 2019-10-11 |
| 1164071817 | Danyelle Denise Pividori | Licensed Vocational Nurse | 992 Marlandwood Rd, Temple, TX 76502 | 2019-09-05 |
| 1831670652 | Jane Lida Jarosz | Registered Nurse | 99 Marlandwood, Temple, TX 76502 | 2018-08-29 |
| 1043791809 | Elsa Gamban Baker | Licensed Practical Nurse | 5711 Hopkins Dr, Temple, TX 76502 | 2018-08-28 |
| 1659859288 | Laura Bright | Licensed Vocational Nurse | 990 Marlanwood, Temple, TX 76502 | 2018-08-06 |
| 1811489974 | Rockdale Blackhawk, LLC | Clinic/Center | 1909 Sw Hk Dodgen Loop, Temple, TX 76502 | 2018-06-05 |
| 1871094573 | Moc Temple, LLC | Skilled Nursing Facility | 725 Marlandwood Rd., Temple, TX 76502 | 2018-02-27 |
| Find all providers in zip 76502 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730795766 | Joshua R Ledezma | Nurse Practitioner | 2401 S 31st St, Temple, TX 76508-0001 | 2020-09-15 |
| 1285259309 | Amanda Lea Johnson | Nurse Practitioner | 2401 S 31st St, Temple, TX 76508-0001 | 2020-06-15 |
| 1861043283 | Wanda Ivette Ortiz | Nurse Practitioner | 2401 S 31st St, Temple, TX 76508-0001 | 2019-09-26 |
| 1871005694 | Karen Cooper | Nurse Practitioner | 2401 S. 31st St, Division of Cardiology, Electrophysiology, and Pacing, Temple, TX 76508 | 2017-11-02 |
| 1841642329 | Kristina Trembly | Nurse Practitioner | 2401 S 31st St, Temple, TX 76508-7709 | 2016-07-07 |
| 1730559097 | Lindsey Diaz | Nurse Practitioner | 2401 S 31st St, Temple, TX 76508-0001 | 2015-09-30 |
| 1083010763 | Anjetta Granvinetta Atkins | Nurse Practitioner | 2401 S 31st St, Temple, TX 76508-0001 | 2014-11-07 |
| 1215281472 | Janalei Eve Stovall | Nurse Practitioner | 2401 S 31st St, Temple, TX 76508 | 2012-11-08 |
| 1043577463 | Moira Jo Pyle | Nurse Practitioner | 546 N Kegley Rd, Temple, TX 76502-4069 | 2012-04-23 |
| 1447521299 | Kathryn Marie Schmidt | Nurse Practitioner | 2401 S 31st St, Temple, TX 76508-0001 | 2012-01-24 |
| Find all providers in TEMPLE | ||||
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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.