MEDICARE: MIRIAM B EEN R.D.

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	133V00000X	Registered Dietitian	16273	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043298847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRIAM B EEN R.D.

Provider Business Mailing Address
First Line	:	2410 FIRE MESA ST
Second Line	:	#180, FAMILY PRACTICE CENTER
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-9016
Country	:	US
Telephone Number	:	702-992-6888
Fax Number	:	702-992-6880

Provider Business Practice Location Address
First Line	:	1524 PINTO LN FL 2
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4195
Country	:	US
Telephone Number	:	702-992-6888
Fax Number	:	702-992-6880

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

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	05/21/2020

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Directions to “ MIRIAM B EEN R.D.” Practice Location

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