MEDICARE: MIRANDA SHEETS

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	163WX0106X	Occupational Health Registered Nurse	916	NE

General Provider Information

NPI Number	:	1952708927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRANDA SHEETS

Provider Business Mailing Address
First Line	:	2701 GRAND AVE TRLR 11
Second Line	:
City	:	KEARNEY
State	:	NE
Zip	:	68847-4121
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1923 W 4TH AVE
Second Line	:
City	:	HOLDREGE
State	:	NE
Zip	:	68949-3113
Country	:	US
Telephone Number	:	308-995-4493
Fax Number	:

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

Provider Enumeration Date	:	11/19/2014
Last Update Date	:	11/19/2014

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Directions to “ MIRANDA SHEETS ” Practice Location

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