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NPI Code Detail

MEDICARE: DR. MIRANDA ROSE LABANT NMD

MEDICARE: DR. MIRANDA ROSE LABANT NMD
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
1175F00000XNaturopath0012NH
2175F00000XNaturopath22-1730AZ

General Provider Information

NPI Number : 1295260446
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIRANDA ROSE LABANT NMD
Provider Business Mailing Address
First Line : 4764 E SUNRISE DR STE 710
Second Line :
City : TUCSON
State : AZ
Zip : 85718-4535
Country : US
Telephone Number : 520-675-5099
Fax Number : 877-263-6841
Provider Business Practice Location Address
First Line : 4764 E SUNRISE DR STE 710
Second Line :
City : TUCSON
State : AZ
Zip : 85718-4535
Country : US
Telephone Number : 520-675-5099
Fax Number : 877-263-6841
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2017
Last Update Date : 01/06/2025

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