Individual
MIRANDA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1590 FREEDOM BLVD STE B, FLORENCE, SC 29505-6071
(843) 665-9581
Mailing address
PO BOX 602108, CHARLOTTE, NC 28260-2108
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23133
SC
Other
Enumeration date
12/08/2019
Last updated
04/09/2020
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