Provider Demographics
NPI:1053382739
Name:MITCHELL, JUDITH A (ARNP)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:248 PLEASANT ST
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2588
Mailing Address - Country:US
Mailing Address - Phone:603-224-1929
Mailing Address - Fax:603-228-7114
Practice Address - Street 1:248 PLEASANT ST
Practice Address - Street 2:SUITE 1700
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2588
Practice Address - Country:US
Practice Address - Phone:603-224-1929
Practice Address - Fax:603-228-7114
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2020-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH03193623363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
48601SOtherUPIN
NH30009977Medicaid