Provider Demographics
NPI:1184850117
Name:MEZU, ALICIA LYNN (RN, MSN/ED)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:LYNN
Last Name:MEZU
Suffix:
Gender:F
Credentials:RN, MSN/ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4724 HAWKSBURY RD
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-2128
Mailing Address - Country:US
Mailing Address - Phone:410-655-7037
Mailing Address - Fax:410-922-6749
Practice Address - Street 1:4724 HAWKSBURY RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-2128
Practice Address - Country:US
Practice Address - Phone:410-655-7037
Practice Address - Fax:410-922-6749
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR126920163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse