| Doctor Name: | JENNIFER R. MIZAK |
| NPI Number: | 1033208186 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.N.P. |
| License Number: | RN173074 |
| Business Practice Address: | 15201 Euclid Ave East Cleveland, OH - 441122803 |
| Business Phone Number: | 2165415600 |
| Business Fax Number: | |
| Mailing Address: | 15201 Euclid Ave, EAST CLEVELAND |
| State: | OH |
| Postal Code: | 441122803 |
| Phone Number: | 2165415600 |
| Fax Number: | |
| NPI Enumeration Date: | 10/12/2006 |
| NPI Last Update Date: | 11/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | RN173074 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |