Mitchell, Staci Lin

Mitchell, Staci Lin is an individual health care provider with primary practice located at 842 Sunset Lake Blvd Ste 403 , Venice FL 34292-7553. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Mitchell, Staci Lin can be contacted via phone (941) 485-3351.

Contact Information

Primary practice address
842 Sunset Lake Blvd Ste 403 Venice FL 34292-7553
Phone: (941) 485-3351
Fax: (941) 485-7677
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704179085 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APRN9490434 Florida

Profile Details

NPI number 1144306192
LBN Legal business name Mitchell, Staci Lin
Credentials NP, APRN
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2006
Last updated Oct 30th, 2019 - about 5 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 1144306192 NPPES
Michigan MEDICAID 4476850

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