SUSAN MIZELLE PA NPI 1295043602

NPI Information

NPI: 1295043602
Provider Name: SUSAN MIZELLE, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 431-6111
Get Directions

Susan Mizelle, PA is a medical physician assistant in Johnson City, TN. Susan Mizelle, PA NPI is 1295043602. 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:

400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN
ZIP 37604-035
Phone: (423) 431-6111

The NPI 1295043602 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/20/2010 and was last updated on 5/30/2012.

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	363AM0700X	Physician Assistant	Medical	PA1883	TENNESSEE	Yes

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: 11/14/2023

NPI Synchronization or Removal

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