Individual
SAMUEL JOHN MITZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3333 S WADSWORTH BLVD UNIT D100, LAKEWOOD, CO 80227-5117
(303) 205-1090
(303) 205-5534
Mailing address
2907 70TH AVE, GREELEY, CO 80634-8969
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 168226 5
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246925000
—
MN
Enumeration date
08/21/2006
Last updated
09/20/2013
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