Individual
KELLY MIYANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3925 OLD REDWOOD HWY, SANTA ROSA, CA 95403-1719
(707) 566-5248
Mailing address
3925 OLD REDWOOD HWY, SANTA ROSA, CA 95403-1719
(707) 566-5248
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
95037760
CA
Other
Enumeration date
03/24/2026
Last updated
03/24/2026
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