# MIRANDA NICOLE SANDER

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

## Provider details

- **NPI number:** 1265198246
- **Gender:** F
- **Credential:** PMHNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 041504517 | IL | — |
| 163W00000X | Registered Nurse | 2017024672 | MO | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 2021046352 | MO | Yes |

## Other

- **Enumeration date:** 11/13/2021
- **Last updated:** 04/04/2022