Individual
MIRANDA FUNK-GARRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1909 N MORTON AVE, MORTON, IL 61550-1426
(309) 263-9124
Mailing address
5100 RELIABLE PKWY, CHICAGO, IL 60686-0001
(309) 672-4809
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209007704
IL
Other
Enumeration date
08/07/2009
Last updated
08/07/2009
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