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General NPI Number Information
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NPI Number | 1780686865
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Entity Type | Individual
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Provider Name | MITZI DANIELA MUSICK ANP
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Gender | Female
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Dates
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Enumeration Date | 06/02/2005
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 105 W STONE DR STE 3A
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City | KINGSPORT
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State | TN
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Zip | 37660-3365
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Country | US
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Telephone | 423-392-6200
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Fax | 423-390-4411
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Provider Business Mailing Address
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Address Line | PO BOX 9 ATTN: CREDENTIALING
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City | NASHVILLE
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State | TN
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Zip | 37201-1835
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Country | US
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Telephone | 865-978-6182
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Fax | 855-737-5542
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN0000116388
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0001162148
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN0000007650
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024165213
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License Number State | VA
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