David, Miranda Jo

David, Miranda Jo is an individual health care provider with primary practice located at 11505 W. Hwy. 24 , Divide CO 80814. She recently has only one registered license in Nursing Service Providers / Community Health, which is considered as her primary health care specialty. David, Miranda Jo can be contacted via phone (719) 687-6416.

Contact Information

Primary practice address
11505 W. Hwy. 24 Divide CO 80814
Phone: (719) 687-6416
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Community Health 163WC1500X 128371 Colorado

Profile Details

NPI number 1144390329
LBN Legal business name David, Miranda Jo
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144390329 NPPES
Colorado MEDICAID 51032732

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