Candria Mitchell

Individual provider Active NPI Licensed Vocational Nurse · Silsbee, TX

NPI 1083115604 · NPPES record last updated Feb 28, 2018

Key facts

NPI
1083115604
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
333030 (TX)
Practice address
1100 N 2ND St
Silsbee, TX 77656-3908
Phone
(409) 926-9151
NPI assigned
Feb 28, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
333030TXMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 333030 TX Yes

Addresses

Primary practice location

1100 N 2ND St
Silsbee, TX 77656-3908

Mailing address

1100 N 2ND St
Silsbee, TX 77656-3908

Other providers in Silsbee, TX

All providers in Silsbee, TX · Licensed Vocational Nurse in Texas

Sources for this page

Verify at the official NPI Registry.