Basic Information
| Provider Information | |||||||||
| NPI: | 1528360583 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MITZEL | ||||||||
| FirstName: | NATALIE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7467 ARAMIS ST NW | ||||||||
| Address2: | |||||||||
| City: | MASSILLON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 446461993 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308308666 | ||||||||
| FaxNumber: | 3308323499 | ||||||||
| Practice Location | |||||||||
| Address1: | 2823 AARONWOOD AVE NE | ||||||||
| Address2: | |||||||||
| City: | MASSILLON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 446462371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308308666 | ||||||||
| FaxNumber: | 3308323499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2010 | ||||||||
| LastUpdateDate: | 12/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | COA.12000-NP | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | COA.12000-NP | 01 | OHI LICENSE | OTHER |