NPI | 1740686880 |
---|---|
Former Name | JENNIFER L MIZELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71005236A) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71005236A) |
363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71005236A) | |
Enumeration Date | 2014-11-18 |
Last Update Date | 2016-05-16 |