Provider Demographics
NPI:1215134044
Name:MIZE, NANCY L (OD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:L
Last Name:MIZE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:143 W FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-2539
Mailing Address - Country:US
Mailing Address - Phone:919-968-3937
Mailing Address - Fax:919-932-3290
Practice Address - Street 1:114 W FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-2516
Practice Address - Country:US
Practice Address - Phone:919-968-3937
Practice Address - Fax:919-932-3290
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1196152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1196OtherNC LICENSE NUMBER
NCMM0066426OtherDEA NUMBER