Provider Demographics
NPI:1801363346
Name:DOSS, MIRA LYNNE (CNA)
Entity Type:Individual
Prefix:MS
First Name:MIRA
Middle Name:LYNNE
Last Name:DOSS
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 1:4831 WALFORD RD APT 12
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-7327
Mailing Address - Country:US
Mailing Address - Phone:440-319-9422
Mailing Address - Fax:
Practice Address - Street 1:4831 WALFORD RD APT 12
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-7327
Practice Address - Country:US
Practice Address - Phone:440-319-9422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty