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NPI Code Detail

MEDICARE: MRS. MARY ANN MARCELLA MIRANDA APRN, AHCNS-BC

MEDICARE:  MRS. MARY ANN MARCELLA MIRANDA  APRN, AHCNS-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1364SA2200XAdult Health Clinical Nurse Specialist734523TX

General Provider Information

NPI Number : 1023263720
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY ANN MARCELLA MIRANDA APRN, AHCNS-BC
Provider Business Mailing Address
First Line : 3200 W SLAUGHTER LN
Second Line : C/O WEST OAKS REHABILITATION AND HEALTHCARE CENTER
City : AUSTIN
State : TX
Zip : 78748-5706
Country : US
Telephone Number : 512-992-7836
Fax Number : 512-364-0654
Provider Business Practice Location Address
First Line : 3200 W SLAUGHTER LN
Second Line : C/O WEST OAKS REHABILITATION AND HEALTHCARE CENTER
City : AUSTIN
State : TX
Zip : 78748-5706
Country : US
Telephone Number : 512-992-7836
Fax Number : 512-364-0654
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2008
Last Update Date : 01/10/2015

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