MEDICARE: MIRANDA KAY BELCHER R.N.

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
1	163W00000X	Registered Nurse	RN335436	OH

General Provider Information

NPI Number	:	1922317940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRANDA KAY BELCHER R.N.

Provider Business Mailing Address
First Line	:	20047 COUNTY ROAD H50
Second Line	:
City	:	WEST UNITY
State	:	OH
Zip	:	43570-9748
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20047 COUNTY ROAD H50
Second Line	:
City	:	WEST UNITY
State	:	OH
Zip	:	43570-9748
Country	:	US
Telephone Number	:	419-438-8582
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2010
Last Update Date	:	09/26/2010

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