Individual provider · Type 1 NPI
Stacey Lasandra Mitchell, NP
Psychiatric/Mental Health Nurse Practitioner · Fayetteville, GA
NPI number
1245794387
Active
Practice location
320 Lanier Ave W Ste 200
Fayetteville, GA 30214-7443
Fax (470) 381-1502
Mailing address
1415 Highway 85 N Ste 310-390
Fayetteville, GA 30214-7738
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 403153 (NY) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 203475 (GA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1245794387
Stacey Lasandra Mitchell, NP's National Provider Identifier is 1245794387, issued on Jan 23, 2019. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Fayetteville, GA. The record was last updated on Sep 16, 2024.