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Individual

MEGAN MIRANDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
735 W 5TH ST, LA PLACE, LA 70068-5505
(985) 652-9504
Mailing address
75 SHEARWATER DR, LA PLACE, LA 70068-6451
(504) 201-7583

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP08525
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01505763
MS
05
2405217
LA
Enumeration date
09/21/2015
Last updated
02/24/2016
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