Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 01843 | OH |
NPI | 1083793137 |
---|---|
Provider Name | Ms. Theresa Marie Mizer |
First Address | Cadiz, OH 43907-1109 |
Second Address | Steubenville, OH 43952-2122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 08/07/2007 |