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General NPI Number Information
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NPI Number | 1083793137
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Entity Type | Individual
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Provider Name | THERESA MARIE MIZER CNP
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Gender | Female
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 217 WASHINGTON ST
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City | STEUBENVILLE
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State | OH
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Zip | 43952-2122
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Country | US
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Telephone | 740-282-5676
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Fax | 740-284-1640
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Provider Business Mailing Address
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Address Line | 213 W MARKET ST
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City | CADIZ
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State | OH
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Zip | 43907-1109
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Country | US
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Telephone | 740-942-2034
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 01843
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License Number State | OH
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