MEDICARE: MIRANDA RENEE EMPLIT

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	376K00000X	Nurse's Aide	600023050425	OH

General Provider Information

NPI Number	:	1265382022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRANDA RENEE EMPLIT

Provider Business Mailing Address
First Line	:	1410 SHADOWRIDGE AVE NE
Second Line	:
City	:	ALLIANCE
State	:	OH
Zip	:	44601-5525
Country	:	US
Telephone Number	:	234-240-0921
Fax Number	:

Provider Business Practice Location Address
First Line	:	1410 SHADOWRIDGE AVE NE
Second Line	:
City	:	ALLIANCE
State	:	OH
Zip	:	44601-5525
Country	:	US
Telephone Number	:	234-240-0921
Fax Number	:

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

Provider Enumeration Date	:	01/31/2026
Last Update Date	:	02/02/2026

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Directions to “ MIRANDA RENEE EMPLIT ” Practice Location

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