| 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 |