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 |