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NPI Code Detail

MEDICARE: JENISE ANN MIZELL

MEDICARE:   JENISE ANN MIZELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1326852443
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENISE ANN MIZELL
Provider Business Mailing Address
First Line : 4721 DUXHALL DR
Second Line :
City : LINCOLN
State : NE
Zip : 68516-3116
Country : US
Telephone Number : 402-525-6191
Fax Number :
Provider Business Practice Location Address
First Line : 1836 MORNINGSIDE DR
Second Line :
City : LINCOLN
State : NE
Zip : 68506-2338
Country : US
Telephone Number : 402-525-6191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2025
Last Update Date : 02/07/2025

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Directions to “ JENISE ANN MIZELL ” Practice Location

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