Individual
MIRANDA KORRIN PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
101 FOX ST, SIDNEY, NY 13838-1530
(607) 434-4209
Mailing address
101 FOX ST, SIDNEY, NY 13838-1530
(607) 434-4209
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
329267
NY
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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