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NPI Code Detail

MEDICARE: MIRANDA OVANA YEOMANS

MEDICARE: MIRANDA OVANA YEOMANS
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1891504734
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRANDA OVANA YEOMANS
Provider Business Mailing Address
First Line : 1227 N PARK AVE APT 101
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2657
Country : US
Telephone Number : 765-412-9533
Fax Number :
Provider Business Practice Location Address
First Line : 1227 N PARK AVE APT 101
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2657
Country : US
Telephone Number : 765-412-9533
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2025
Last Update Date : 01/06/2025

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Directions to “ MIRANDA OVANA YEOMANS ” Practice Location

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