| NPI | 1538595640 |
|---|---|
| Former Name | MICHELLE S MIZELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A100736) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G164931) |
| Enumeration Date | 2013-09-20 |
| Last Update Date | 2022-09-23 |