Individual
SOTHEA MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
222 MAIN ST, WILMINGTON, MA 01887-2341
(978) 658-3377
Mailing address
52 OAKLAND ST, MALDEN, MA 02148-6618
(781) 605-8715
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2276407
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2276407
MA
Other
Enumeration date
09/12/2021
Last updated
11/24/2021
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