Individual
MIRANDA ODEGARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10561 E CAMINO CIR, MESA, AZ 85207-3145
(480) 758-0716
Mailing address
10561 E CAMINO CIR, MESA, AZ 85207-3145
(480) 758-0716
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
236747
AZ
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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