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Individual
MIRANDA DESANCTIS
Active
Individual
MIRANDA DESANCTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
348262
NY
363LS0200X
School Nurse Practitioner
677427-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
348262
LICENSE
NY
01
—
677427-1
LICENSE
NY
Enumeration date
06/29/2021
Last updated
09/15/2021
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