Individual
MRS. MIRANDA L BROYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3200 MACCORKLE AVENUE SOUTHWEST, CHARLESTON, WV 25314
(304) 388-5432
Mailing address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 437-1252
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
66284
WV
Other
Enumeration date
12/19/2012
Last updated
06/10/2016
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