# ANDREA BROOKE MIRACLE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1003193624
- **Gender:** F
- **Credential:** PHARM. D

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | 014669 | KY | — |
| 183500000X | Pharmacist | 33135 | TN | Yes |

## Other

- **Enumeration date:** 11/10/2011
- **Last updated:** 11/18/2011