Provider Demographics
NPI:1336447291
Name:FINLEY, MIRIAM (LPN, LMT,NMT)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:FINLEY
Suffix:
Gender:F
Credentials:LPN, LMT,NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 EAST LAMAR STREET
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709
Mailing Address - Country:US
Mailing Address - Phone:229-924-9772
Mailing Address - Fax:
Practice Address - Street 1:1714 EAST LAMAR STREET
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709
Practice Address - Country:US
Practice Address - Phone:229-924-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT002316163WM1400X
GALPN051832164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)
No164W00000XNursing Service ProvidersLicensed Practical Nurse