Provider Demographics
NPI:1992184337
Name:MIZIKAR, JAMIE SUE (RN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:SUE
Last Name:MIZIKAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 TRIANGLE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-3510
Mailing Address - Country:US
Mailing Address - Phone:724-838-8300
Mailing Address - Fax:
Practice Address - Street 1:123 TRIANGLE DR
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3510
Practice Address - Country:US
Practice Address - Phone:724-838-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN567924163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse