Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Destiny Ruosa Mitchell, APRN-CNP

Individual provider Family Nurse Practitioner · NPI 1114309317

Mrs. Destiny Ruosa Mitchell, APRN-CNP is a Nurse Practitioner in Shawnee, Oklahoma. Qualified in 2014, 12 years ago. Practices with Citizen Potawatomi Nation, a 35-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
12
Licensed in
OK
In the registry since
2015
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Practice location Address checks out

781 Grand Casino Blvd
Shawnee, OK 74804-1005
Phone: (405) 964-5770
Fax: (405) 964-5788
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 — (405) 273-5236

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 79374 (OK)

Record details

NPI number1114309317
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN-CNP
Sole proprietorNo
NPI enumeratedJune 24, 2015
Last updated in NPPESApril 24, 2025
Certification dateApril 24, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Citizen Potawatomi Nation — 35 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Shawnee