Provider Demographics
NPI:1164202339
Name:MISE, SYLVIA BARROS (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MISS
First Name:SYLVIA
Middle Name:BARROS
Last Name:MISE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:562 PROSPECT PL # 3
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2914
Mailing Address - Country:US
Mailing Address - Phone:781-724-7517
Mailing Address - Fax:
Practice Address - Street 1:3100 VINE ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2068
Practice Address - Country:US
Practice Address - Phone:513-362-0238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE114961363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care