Provider Demographics
NPI:1720824816
Name:MUSE, MIRANDA MAE (OHIO NURSE AIDE)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:MAE
Last Name:MUSE
Suffix:
Gender:F
Credentials:OHIO NURSE AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3190 MCHENRY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-7343
Mailing Address - Country:US
Mailing Address - Phone:513-375-8984
Mailing Address - Fax:
Practice Address - Street 1:3190 MCHENRY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-7343
Practice Address - Country:US
Practice Address - Phone:513-375-8984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH602478910422376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide