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General NPI Number Information
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NPI Number | 1184335762
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Entity Type | Individual
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Provider Name | MICHAEL SIZEMORE RN, PMHNP, BSN, MSN
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Gender | Male
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Dates
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Enumeration Date | 12/06/2022
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 101 S 10TH ST
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City | RICHMOND
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State | IN
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Zip | 47374-5547
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Country | US
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Telephone | 659-654-2997
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Fax |
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Provider Business Mailing Address
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Address Line | 101 S 10TH ST
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City | RICHMOND
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State | IN
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Zip | 47374-5547
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Country | US
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Telephone | 765-965-4299
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 71013586A
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License Number State | IN
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