Tamara Michelle Mitchell, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN5179703 Issued in FL

Practice address

7 Sederholm Path
Palm Coast, FL 32164-5479

Phone

(386) 225-0208

NPI assigned

Feb 5, 2025

Sex

Female

Sole proprietor

Yes

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": "1738713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1740094044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SEDERHOLM PATH",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645479",
            "telephone_number": "386-225-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 SEDERHOLM PATH",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645479",
            "telephone_number": "386-225-0208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "TAMARA",
        "middle_name": "MICHELLE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5179703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucia Miller
• Zachary Miller, LMHC, MCAP
• Yohanna Mills
• Charles Lester Talan Mitchell, PT, DPT
• Nicole Mitchell
• MJ Investment Enterprises, LLC
• Mlacson Rnfa Services Inc.
• Patricia Isabel Modad, M.D., F.A.C.O.G.
• Nicole Moffett, SLPA
• Muneeruddin Mohammed, M.D.

• Licensed Practical Nurse in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Licensed Practical Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.