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NPI Code Detail

MEDICARE: MIRANDA JOY DAVIS

MEDICARE: MIRANDA JOY DAVIS
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
1163W00000XRegistered Nurse909393TX
2363LN0000XNeonatal Nurse Practitioner1231404TX

General Provider Information

NPI Number : 1063386092
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRANDA JOY DAVIS
Provider Business Mailing Address
First Line : 160 ORCHARD LN
Second Line :
City : KYLE
State : TX
Zip : 78640-4289
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1201 W 38TH ST
Second Line :
City : AUSTIN
State : TX
Zip : 78705-1006
Country : US
Telephone Number : 512-964-8405
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2025
Last Update Date : 04/17/2026

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Directions to “ MIRANDA JOY DAVIS ” Practice Location

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