Individual
JENNIFER R. MIZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.N.P.
Contact information
Practice address
15201 EUCLID AVE, EAST CLEVELAND, OH 44112-2803
(216) 541-5600
Mailing address
15201 EUCLID AVE, EAST CLEVELAND, OH 44112-2803
(216) 541-5600
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN173074
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2135373
—
OH
Enumeration date
10/12/2006
Last updated
11/20/2015
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