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Individual
MISS SHELBY MIRANDA HALL
Active
Individual
MISS SHELBY MIRANDA HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
025325
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/26/2018
Last updated
11/26/2024
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