Provider Demographics
NPI:1235987736
Name:MITCHELL, TASCHA LATRICE (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:TASCHA
Middle Name:LATRICE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 W MOREHEAD ST FL 5
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-5576
Mailing Address - Country:US
Mailing Address - Phone:704-778-4400
Mailing Address - Fax:704-778-4401
Practice Address - Street 1:1213 W MOREHEAD ST FL 5
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-5576
Practice Address - Country:US
Practice Address - Phone:704-778-4400
Practice Address - Fax:704-778-4401
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker