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NPI Code Detail

MEDICARE: MIRANDA WEST

MEDICARE: MIRANDA WEST
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
1175T00000XPeer SpecialistNM

General Provider Information

NPI Number : 1528992096
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRANDA WEST
Provider Business Mailing Address
First Line : 3532 WYOMING BLVD NE APT 106
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87111-4415
Country : US
Telephone Number : 505-272-5935
Fax Number :
Provider Business Practice Location Address
First Line : 2600 MARBLE AVE NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87106-2058
Country : US
Telephone Number : 505-272-5935
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2026
Last Update Date : 06/10/2026

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Directions to “ MIRANDA WEST ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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