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General NPI Number Information
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NPI Number | 1386385482
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Entity Type | Individual
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Provider Name | MIRIAM MEDINA MORALES RN
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Gender | Female
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 330 CAMPUS DR.
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City | HANFORD
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State | CA
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Zip | 93230
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Country | US
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Telephone | 559-380-6602
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Fax | 559-584-5672
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Provider Business Mailing Address
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Address Line | 330 CAMPUS DR.
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City | HANFORD
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State | CA
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Zip | 93230
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Country | US
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Telephone | 559-380-6602
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Fax | 559-584-5672
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95225773
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License Number State | CA
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