Individual
MIRANNDA NICOLE WOODBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1925 WAYCREST DR SW APT 2201, ATLANTA, GA 30331-8467
(850) 590-5187
Mailing address
1925 WAYCREST DR SW APT 2201, ATLANTA, GA 30331-8467
(850) 590-5187
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5221742
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000
N/A
—
Enumeration date
12/01/2020
Last updated
12/01/2020
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