Emily Nicole Mrzlock, APN
Nurse Practitioner, Family in Dyer, IN. Individual provider (NPI-1).
NPI number1679110266
StatusActive
Last updated in NPPESAug 30, 2021
Details
- NPI
- 1679110266
- Entity type
- Individual (NPI-1)
- Name
- Emily Nicole Mrzlock
- Credential
- APN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 3, 2019
- Certification date
- Aug 10, 2021
- Last updated
- Aug 30, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 71009760A | IN | Yes |
| 163W00000X | Registered Nurse | 28224941A | IN |
Practice location
15900 W 101st AveDyer, IN 46311-3065
Phone 219-365-6333 · Fax 219-365-6333
Mailing address
15900 W 101st AveDyer, IN 46311-3065
Phone 219-365-6333 · Fax 219-365-8291
Other practice locations
16000 W 101st Ave
Dyer, IN 46311
Dyer, IN 46311
Phone 219-365-6333 · Fax 219-365-8291
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