NPI Code Details Logo

NPI 1225666423

NPI 1225666423 : MIRANDA HALL DO : HENDERSON, NV

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1225666423
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    MIRANDA HALL DO
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    04/01/2020
-----------------------------------------------------
    Last Update Date     |    08/15/2024
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2845 SIENA HEIGHTS DR 
-----------------------------------------------------
    City                 |    HENDERSON
-----------------------------------------------------
    State                |    NV
-----------------------------------------------------
    Zip                  |    89052-4153
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    702-877-5199
-----------------------------------------------------
    Fax                  |    702-384-7139
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 35380 
-----------------------------------------------------
    City                 |    LAS VEGAS
-----------------------------------------------------
    State                |    NV
-----------------------------------------------------
    Zip                  |    89133-5380
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    702-954-7699
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207V00000X
-----------------------------------------------------
    Taxonomy Name        |    Obstetrics & Gynecology Physician
-----------------------------------------------------
    License Number       |    5151014346
-----------------------------------------------------
    License Number State |    MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    207V00000X
-----------------------------------------------------
    Taxonomy Name        |    Obstetrics & Gynecology Physician
-----------------------------------------------------
    License Number       |    DO3711
-----------------------------------------------------
    License Number State |    NV
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.