Mizak, Vanessa Kelly
Mizak, Vanessa Kelly is an individual health care provider with primary practice located at 3600 Nw Samaritan Dr Ste 227 , Corvallis OR 97330-3737. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Mizak, Vanessa Kelly can be contacted via phone (541) 768-1261.Contact Information
Primary practice address
3600 Nw Samaritan Dr Ste 227
Corvallis OR 97330-3737
Phone: (541) 768-1261
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 0993810 | Colorado |
| Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist | 364S00000X | 201804762CNS | Oregon |
| Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist | 364S00000X | APN.0991563-CNS | Colorado |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 201804760NP-PP | Oregon |
Profile Details
| NPI number | 1669860979 |
|---|---|
| LBN Legal business name | Mizak, Vanessa Kelly |
| Credentials | FNP-C, AGCNS-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 8th, 2015 |
| Last updated | Sep 13th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669860979 | NPPES |
| Colorado | MEDICAID | 85780073 | |
| Colorado | Other | P01618686 |
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