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Individual

MR. BRYAN MIZNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3203 OSBORNE DR W STE 101, HASTINGS, NE 68901-9122
(402) 834-1005
(402) 303-1022
Mailing address
720 N WEBB RD, GRAND ISLAND, NE 68803-3310
(308) 384-2500
(308) 384-2565

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
079794
PHYSICIAN ASSISTANT LICENSE
IA
05
1770950875
IA
05
420680355-12
NE
Enumeration date
08/25/2015
Last updated
09/20/2017
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