Lori Lynn Miebach
Nurse Practitioner (Gerontology)

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 Identifier (NPI) 1003334558
Entity Type Individual
Full Name Lori Lynn Miebach
Credential RN, AGNP-C
Gender Female
Practice Address 405 County Road 3820
San Antonio
TX 78253-6903
Practice Telephone (210) 508-0356
Mailing Address 405 County Road 3820
San Antonio
TX 78253-6903
Mailing Telephone 2105080356
Sole Proprietor Yes, this individual is a Sole Proprietor
Enumeration Date 2017-09-05
Last Update Date 2017-09-05

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363LG0600X Nurse Practitioner · Gerontology Physician Assistants & Advanced Practice Nursing Providers AP135036 TX

Physician Overview

NPI 1003334558
PAC ID by PECOS 3779849278
Professional Enrollment ID I20171116002118
Full Name Lori Lynn Miebach
Organization Legal Name MED MANAGEMENT ASSOCIATES
Phone Number 8302492594
Gender F
Graduation Year 2017
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 7810299187
Number of Group Practice Members 4
Accepts Medicare Assignment Y

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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Office Location

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

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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.