Individual
MIRANDA LYNN WIRTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
410 S ADEWAY STE C, FOWLER, IN 47944-8418
(765) 884-1343
(765) 884-2026
Mailing address
410 S ADEWAY STE C, FOWLER, IN 47944-8418
(765) 884-1343
(765) 884-2026
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28238968A
IN
163WC1500X
Community Health Registered Nurse
28238968A
IN
Other
Enumeration date
02/28/2022
Last updated
03/02/2022
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