Provider Demographics
NPI:1083178370
Name:GHIRMAY, MICKY K (RN)
Entity Type:Individual
Prefix:
First Name:MICKY
Middle Name:K
Last Name:GHIRMAY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 W 27TH ST APT 313
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90018-5203
Mailing Address - Country:US
Mailing Address - Phone:404-610-3185
Mailing Address - Fax:
Practice Address - Street 1:3730 W 27TH ST APT 313
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90018-5203
Practice Address - Country:US
Practice Address - Phone:404-610-3185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide