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
Fax:
Website:

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 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669860979 NPPES
Colorado MEDICAID 85780073
Colorado Other P01618686

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