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Organization
MYMIRA HEALTHCARE SERVICES LLC
Active
Organization
MYMIRA HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIANDA NDAPTSO NP (CEO)
(678) 497-5145
Entity
Organization
Contact information
Practice address
3008 EDGEFIELD DR SW, MARIETTA, GA 30008-7665
(678) 497-5145
Mailing address
3008 EDGEFIELD DR SW, MARIETTA, GA 30008-7665
(678) 497-5145
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
NULL
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
NULL
261Q00000X
Clinic/Center
—
NULL
261QC1500X
Community Health Clinic/Center
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/31/2022
Last updated
08/31/2022
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