Individual
MIRIAM E FERNANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
12 CODY LN, RAYNHAM, MA 02767-5230
(508) 623-6765
Mailing address
2460 PRAIA PL APT 12, DULLES, VA 20189-2460
(508) 623-6765
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2314619
MA
Other
Enumeration date
10/21/2022
Last updated
03/10/2026
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