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NPI Code Detail

MEDICARE: MIRANDA SERMERSHEIM OT

MEDICARE: MIRANDA SERMERSHEIM OT
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
1225X00000XOccupational TherapistBOTOCT00224694KY

General Provider Information

NPI Number : 1588118681
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRANDA SERMERSHEIM OT
Provider Business Mailing Address
First Line : 2831 NEW HARTFORD RD
Second Line :
City : OWENSBORO
State : KY
Zip : 42303-1320
Country : US
Telephone Number : 812-477-1558
Fax Number :
Provider Business Practice Location Address
First Line : 800 W 9TH ST
Second Line :
City : JASPER
State : IN
Zip : 47546-2516
Country : US
Telephone Number : 812-996-0682
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2016
Last Update Date : 03/28/2022

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Directions to “ MIRANDA SERMERSHEIM OT” Practice Location

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