| Doctor Name: | MS. NICOLE L. MIZNER |
| NPI Number: | 1003049768 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C.P.N.P. |
| License Number: | AP091039 |
| Business Practice Address: | 887 Congress St Suite 310 Portland, ME - 041023100 |
| Business Phone Number: | 2077732723 |
| Business Fax Number: | 2077733941 |
| Mailing Address: | 887 Congress St, Suite 310 PORTLAND |
| State: | ME |
| Postal Code: | 041023100 |
| Phone Number: | 2077732723 |
| Fax Number: | 2077733941 |
| NPI Enumeration Date: | 08/28/2009 |
| NPI Last Update Date: | 08/28/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | AP091039 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |