Individual
REBEKKAH MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-ACNP
Contact information
Practice address
15123 S HEATHER STONE CIR, DRAPER, UT 84020-5718
(843) 263-4258
Mailing address
329 E 400 S, PROVO, UT 84606-4735
(843) 263-4258
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
8311663-4405
UT
Other
Enumeration date
10/04/2023
Last updated
10/04/2023
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