Provider Demographics
NPI:1194041848
Name:HOUSER, MISHA L (CNA)
Entity Type:Individual
Prefix:MS
First Name:MISHA
Middle Name:L
Last Name:HOUSER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 SIMUEL LN
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36067-5502
Mailing Address - Country:US
Mailing Address - Phone:334-380-6552
Mailing Address - Fax:
Practice Address - Street 1:855 SIMUEL LN
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36067-5502
Practice Address - Country:US
Practice Address - Phone:334-380-6552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide