Provider Demographics
NPI:1457114779
Name:MIZELL, BROOKE MICHELLE (NP)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:MICHELLE
Last Name:MIZELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 WHISPERING PINES DR
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-2071
Mailing Address - Country:US
Mailing Address - Phone:423-605-4707
Mailing Address - Fax:
Practice Address - Street 1:24 WHISPERING PINES DR
Practice Address - Street 2:
Practice Address - City:SIGNAL MOUNTAIN
Practice Address - State:TN
Practice Address - Zip Code:37377-2071
Practice Address - Country:US
Practice Address - Phone:423-605-4707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35289363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily