Reva Shane Mitchell
Licensed Practical Nurse in Columbus, OH. Individual provider (NPI-1).
NPI number1063103752
StatusActive
Last updated in NPPESMay 15, 2023
Details
- NPI
- 1063103752
- Entity type
- Individual (NPI-1)
- Name
- Reva Shane Mitchell
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 15, 2023
- Certification date
- May 15, 2023
- Last updated
- May 15, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 180908 | OH | Yes |
Practice location
2810 Fern AveColumbus, OH 43211-1730
Phone 614-999-5152
Mailing address
2810 Fern AveColumbus, OH 43211-1730
Phone 614-999-5152
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 1,055 Licensed Practical Nurse providers in Columbus · All 44,944 providers in Columbus
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