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NPI Code Detail

MEDICARE: MICHAEL MIADZIELEC CNP, PMHNP-BC

MEDICARE: MICHAEL MIADZIELEC CNP, PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner0041337OH

General Provider Information

NPI Number : 1437414570
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL MIADZIELEC CNP, PMHNP-BC
Provider Business Mailing Address
First Line : 3556 LAUREL DR
Second Line :
City : PERRY
State : OH
Zip : 44081-9778
Country : US
Telephone Number : 440-368-2526
Fax Number :
Provider Business Practice Location Address
First Line : 60 WEST ST
Second Line :
City : GENEVA
State : OH
Zip : 44041-9723
Country : US
Telephone Number : 440-368-2526
Fax Number : 440-361-3397
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2012
Last Update Date : 04/10/2026

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