Mirisciotti, Shirley A
Mirisciotti, Shirley A is an individual health care provider with primary practice located at 75 Sylvania Dr , Beavercreek OH 45440-3237. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Mirisciotti, Shirley A can be contacted via phone (937) 320-5050.Contact Information
Primary practice address
75 Sylvania Dr
Beavercreek OH 45440-3237
Phone: (937) 320-5050
Fax: (937) 320-5060
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 50.002363 | Ohio |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 50.002363RX | Ohio |
Profile Details
| NPI number | 1902021975 |
|---|---|
| LBN Legal business name | Mirisciotti, Shirley A |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 16th, 2007 |
| Last updated | Aug 25th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902021975 | NPPES |
| Ohio | MEDICAID | 0147626 |
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