Individual
MIRANDA RENEE WING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
725 RESERVOIR AVE STE 103, CRANSTON, RI 02910-4451
(401) 829-4446
(401) 829-4434
Mailing address
725 RESERVOIR AVE STE 103, CRANSTON, RI 02910-4451
(401) 829-4446
(401) 829-4434
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN01755
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2316320
—
LA
Enumeration date
07/13/2012
Last updated
10/01/2024
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