Miranda L Yousif
Student in an Organized Health Care Education/Training Program in Phoenix, AZ. Individual provider (NPI-1).
NPI number1104684232
StatusActive
Last updated in NPPESMay 21, 2025
Details
- NPI
- 1104684232
- Entity type
- Individual (NPI-1)
- Name
- Miranda L Yousif
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 12, 2024
- Certification date
- May 21, 2025
- Last updated
- May 21, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - DERMATOLOGY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
26224 N Tatum Blvd Ste 5Phoenix, AZ 85050-7500
Phone 480-882-7580
Mailing address
26224 N Tatum Blvd Ste 5Phoenix, AZ 85050-7500
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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