Individual
MIRANDA HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1891 FORT RD, 11, SHERIDAN, WY 82801
(307) 672-3473
Mailing address
345 W 3RD ST, PARKER, SD 57053-2269
(605) 351-1891
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
R054984
SD
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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