MEDICARE: DR. MIRANDA HUEPERS ND, FNP-BC

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	175F00000X	Naturopath	AHC-NAT-LIC-2121	MT
2	363LF0000X	Family Nurse Practitioner	1104634	TX
3	363LF0000X	Family Nurse Practitioner	869707	NV

General Provider Information

NPI Number	:	1316579246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIRANDA HUEPERS ND, FNP-BC

Provider Business Mailing Address
First Line	:	605 EL GUSTO AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-4427
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1771 E FLAMINGO RD STE 201A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5157
Country	:	US
Telephone Number	:	725-529-9288
Fax Number	:	725-712-0766

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

Provider Enumeration Date	:	02/08/2020
Last Update Date	:	07/21/2025

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