Provider Demographics
NPI:1831954346
Name:MIZUSHIMA, YOKO (FNP-BC)
Entity type:Individual
Prefix:
First Name:YOKO
Middle Name:
Last Name:MIZUSHIMA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11174 MINNETTA CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-5887
Mailing Address - Country:US
Mailing Address - Phone:904-472-1355
Mailing Address - Fax:
Practice Address - Street 1:11174 MINNETTA CT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-5887
Practice Address - Country:US
Practice Address - Phone:904-472-1355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11023234363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily