Healthcare Provider Details

I. General information

NPI: 1164202339
Provider Name (Legal Business Name): SYLVIA MISE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2023
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 OLSON DR STE 101
PAPILLION NE
68046-2981
US

IV. Provider business mailing address

562 PROSPECT PL # 3
CINCINNATI OH
45229-2914
US

V. Phone/Fax

Practice location:
  • Phone: 402-933-6300
  • Fax: 402-916-5078
Mailing address:
  • Phone: 781-724-7517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number114961
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number114961
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number114961
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: