Mitzen, Kelly
Mitzen, Kelly is an individual health care provider with primary practice located at Dilorenzo Tricare Health Clinic Army Pentagon 5801, Washington DC 20310-2802. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Mitzen, Kelly can be contacted via phone (703) 692-8950.Contact Information
Primary practice address
Dilorenzo Tricare Health Clinic Army Pentagon 5801
Washington DC 20310-2802
Phone: (703) 692-8950
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 0110002992 | Virginia |
Profile Details
| NPI number | 1073584777 |
|---|---|
| LBN Legal business name | Mitzen, Kelly |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 30th, 2006 |
| Last updated | Mar 20th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073584777 | NPPES |
| Other | 1073584777 | NPI |
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