Provider Demographics
NPI:1962134023
Name:HABIG, MIRANDA PAIGE (RN)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:PAIGE
Last Name:HABIG
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 1:4353 SAINT MARTINS PLACE
Mailing Address - Street 2:
Mailing Address - City:CHEVIOT
Mailing Address - State:OH
Mailing Address - Zip Code:45211
Mailing Address - Country:US
Mailing Address - Phone:513-560-4981
Mailing Address - Fax:
Practice Address - Street 1:3300 MERCY HEALTH BLVD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211
Practice Address - Country:US
Practice Address - Phone:513-215-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH465938163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN.465938OtherRN LICENSE NUMBER