KRISTEN J MIZUMOTO NP NPI 1225388689

NPI Information

NPI: 1225388689
Provider Name: KRISTEN J MIZUMOTO, NP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
5930 HEISLEY RD
NEIGHBORING
MENTOR, OH
ZIP 44060
Phone: (440) 639-3509
Get Directions

Kristen J Mizumoto, NP is a psychiatric/mental health nurse practitioner in Mentor, OH. Kristen J Mizumoto, NP NPI is 1225388689. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5930 HEISLEY RD
NEIGHBORING
MENTOR, OH
ZIP 44060-834
Phone: (440) 639-3509
Fax: (440) 352-2040

The NPI 1225388689 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 9/13/2012 and was last updated on 1/31/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	COA13309	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2362429	MEDICAID	OHIO
2	9282481	MEDICARE UPIN	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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