Individual
MRS. MIRANDA D WITHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
349 BOGLE ST STE A, SOMERSET, KY 42503-2895
(606) 679-0179
(606) 679-0546
Mailing address
349 BOGLE ST STE A, SOMERSET, KY 42503-2895
(606) 679-0179
(606) 679-0546
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6526P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100130590
—
KY
Enumeration date
06/28/2010
Last updated
12/02/2014
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