Jevon Patrick Gegg-Mitchell, PA-C, FNP, RN
Nurse Practitioner, Family in Stanford, CA. Individual provider (NPI-1).
NPI number1245500065
StatusActive
Last updated in NPPESSep 28, 2016
Details
- NPI
- 1245500065
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jevon Patrick Gegg-Mitchell
- Credential
- PA-C, FNP, RN
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 10, 2012
- Last updated
- Sep 28, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 95000037 | CA | Yes |
| 163W00000X | Registered Nurse | 769525 | CA | |
| 363A00000X | Physician Assistant | PA22395 | CA |
Practice location
300 Pasteur DrStanford, CA 94305-2200
Phone 650-723-4000
Mailing address
1804 Embarcadero RdSte 100
Palo Alto, CA 94303-3341
Phone 650-723-4000
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