MEDICARE: JEAN SHERRI MIERA M.S.

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	235Z00000X	Speech-Language Pathologist	C-4801	NM

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	:	1154631547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN SHERRI MIERA M.S.

Provider Business Mailing Address
First Line	:	2557 CHESSMAN DR NE
Second Line	:
City	:	RIO RANCHO
State	:	NM
Zip	:	87124-6517
Country	:	US
Telephone Number	:	505-480-9733
Fax Number	:

Provider Business Practice Location Address
First Line	:	2557 CHESSMAN DR NE
Second Line	:
City	:	RIO RANCHO
State	:	NM
Zip	:	87124-6517
Country	:	US
Telephone Number	:	505-480-9733
Fax Number	:

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

Provider Enumeration Date	:	10/19/2010
Last Update Date	:	10/19/2010

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Directions to “ JEAN SHERRI MIERA M.S.” Practice Location

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