Miranda Paige Wallace, is a
Student In An Organized Health Care Education/training Program based in Hurricane, Utah. Miranda Paige Wallace is licensed to practice in * (Not Available) (license number ) and her current practice location is
4 S 2600 W Ste 6, Hurricane, Utah. She can be reached at her office (for appointments etc.) via phone at
(435) 229-8405.
NPI number for Miranda Paige Wallace is 1164134094 and her current mailing address is 101 S Main St, Hurricane, Utah. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1164134094.
Healthcare Provider's Profile
| Full Name | Miranda Paige Wallace |
|---|
| Gender | Female |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 4 S 2600 W Ste 6, Hurricane, Utah |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1164134094
- Provider Enumeration Date: 12/22/2022
- Last Update Date: 12/22/2022
Medical Identifiers
Medical identifiers for Miranda Paige Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164134094 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miranda Paige Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Miranda Paige Wallace,
101 S Main St,
Hurricane, UT 84737-2631
Ph: (318) 355-3099 | Miranda Paige Wallace,
4 S 2600 W Ste 6,
Hurricane, UT 84737-3247
Ph: (435) 229-8405 |
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