Individual
ISABELLA LARA MIZELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-1000
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
13284667-4405
UT
363LP0200X
Pediatric Nurse Practitioner
Primary
13284667-4405
UT
Other
Enumeration date
03/14/2023
Last updated
12/03/2023
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