Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Charles Itoe Misori, CRNP

Individual provider Nurse Practitioner · NPI 1629171293

Mr. Charles Itoe Misori, CRNP is a Nurse Practitioner in Dallas, Texas. Qualified in 2004, 22 years ago. Accepts Medicare assignment. Licensed in Alabama.

Years since qualifying
22
Licensed in
AL
In the registry since
2006
Specialties on file
2
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

2223 S Buckner Blvd
Dallas, TX 75227-8646
Phone: (305) 266-2929
Fax: (786) 558-0242
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 1094507 (AL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 1094507 (AL)

Record details

NPI number1629171293
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNP
Sole proprietorNo
NPI enumeratedSeptember 7, 2006
Last updated in NPPESJanuary 5, 2023
Certification dateJanuary 5, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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