Provider Demographics
NPI:1093487712
Name:MVE, MIRABELL N
Entity Type:Individual
Prefix:
First Name:MIRABELL
Middle Name:N
Last Name:MVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9236 WHISKEY BOTTOM RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1326
Mailing Address - Country:US
Mailing Address - Phone:202-940-3606
Mailing Address - Fax:
Practice Address - Street 1:9236 WHISKEY BOTTOM RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-1326
Practice Address - Country:US
Practice Address - Phone:202-940-3606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNA0000813180374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide