Provider Demographics
NPI:1063262095
Name:YOUNES, MIRABELLE (RN)
Entity type:Individual
Prefix:
First Name:MIRABELLE
Middle Name:
Last Name:YOUNES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 BLACKSTONE ST
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:MA
Mailing Address - Zip Code:01756-1309
Mailing Address - Country:US
Mailing Address - Phone:508-330-3984
Mailing Address - Fax:
Practice Address - Street 1:162 BLACKSTONE ST
Practice Address - Street 2:
Practice Address - City:MENDON
Practice Address - State:MA
Practice Address - Zip Code:01756-1309
Practice Address - Country:US
Practice Address - Phone:508-330-3984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2354629163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse