LORI LYNN MIEBACH


Address: 405 County Road 3820, San Antonio, TX 78253-6903
Phone: (210) 508-0356

LORI LYNN MIEBACH (NPI# 1003334558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003334558
Entity Type Individual
Full Name LORI LYNN MIEBACH
Credential RN, AGNP-C
Practice Address 405 County Road 3820
San Antonio
TX 78253-6903
Practice Telephone (210) 508-0356
Mailing Telephone 2105080356
Enumeration Date 2017-09-05
Last Update Date 2017-09-05
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
AP135036 TX Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 405 COUNTY ROAD 3820
City SAN ANTONIO
State TX
Zip Code 78253-6903

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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

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Competitor

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City SAN ANTONIO
Zip Code 78253

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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