Mitchell, Kory Lance

Mitchell, Kory Lance is an individual health care provider with primary practice located at 3502 9Th St Ste 260 , Lubbock TX 79415-5305. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Medical-Surgical, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is his primary health care specialty. Mitchell, Kory Lance can be contacted via phone (806) 792-8185.

Contact Information

Primary practice address
3502 9Th St Ste 260 Lubbock TX 79415-5305
Phone: (806) 792-8185
Fax: (806) 792-9180
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Medical-Surgical 163WM0705X 663921 Texas
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X AP114881 Texas

Profile Details

NPI number 1588735104
LBN Legal business name Mitchell, Kory Lance
Credentials ACUTE CARE NURSE PRA
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated Aug 29th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588735104 NPPES
Texas Other 8Y1753 BCBS OF TEXAS
Texas MEDICAID 45939268 BCBS OF TEXAS
Texas Other 8Y5044 BCBS OF TEXAS
Texas Other 151566101 BCBS OF TEXAS

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