Most Relevant Information
Provider Data
| NPI Number: | 1003049768 |
| Provider Name: | NICOLE L. MIZNER C.P.N.P. |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0200X |
| Specialty: | Nurse Practitioner |
| License Number: | AP091039 |
Most Important Dates
| Enumeration Date: | 08/28/2009 |
| Last Updated: | 08/28/2009 |
Provider Practice Location
887 CONGRESS ST
SUITE 310
PORTLAND
ME
041023100
Practice Location Phone/Fax
| Phone: | 2077732723 |
| Fax: | 2077733941 |
Provider Mailing Location
887 CONGRESS ST
SUITE 310
PORTLAND
ME
041023100
Provider Mailing Phone/Fax
| Phone: | 2077732723 |
| Fax: | 2077733941 |