Healthcare Provider Details

I. General information

NPI: 1538595640
Provider Name (Legal Business Name): MICHELLE S PRISNER DNP FNP-BC PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MICHELLE S MIZELL RN

II. Dates (important events)

Enumeration Date: 09/20/2013
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 OAK ST
BURLINGTON IA
52601-0801
US

IV. Provider business mailing address

903 OAK ST
BURLINGTON IA
52601-4608
US

V. Phone/Fax

Practice location:
  • Phone: 319-209-2150
  • Fax: 319-209-2149
Mailing address:
  • Phone: 319-209-2150
  • Fax: 319-209-2149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA100736
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG164931
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: