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MIRANDA RENEA PIERCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-5851
(502) 852-3762
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
(502) 587-4784

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3015022
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300043814
IN
05
7100694880
KY
Enumeration date
09/03/2020
Last updated
11/05/2020
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