Mitzi Brutus Mitchell, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN165674 Issued in GA

Practice address

104 Windsor Way
Riverdale, GA 30274-3659

Phone

(678) 490-5490

NPI assigned

Jan 21, 2011

Last updated

Jan 21, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295568000000",
    "number": "1730484866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 MOUNT ZION RD # 293",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302603313",
            "telephone_number": "678-490-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WINDSOR WAY",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302743659",
            "telephone_number": "678-490-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MITZI",
        "middle_name": "BRUTUS",
        "name_prefix": "Ms.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-21",
        "last_updated": "2011-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN165674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindscape Wellness Center LLC
• Minimally Invasive Neurospine and Pain Institute, PC (AllSpine Surgery center)
• Harold Mitchell Jr., OTD
• Lula Sherri M Mitchell, PA
• Meosha Mitchell, CNA
• Mobile Home Health Aide Services
• Mobile Nursing Service LLC
• Bhat Krishna Mohan, MD
• Siva B Mohan, M.D.
• Obiageli Gloria Moneke

• Registered Nurse in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.