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Individual

MIRANDA N ALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 224-4000
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 952-2111

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
29447
TN
363LF0000X
Family Nurse Practitioner
Primary
29447
TN
363LP2300X
Primary Care Nurse Practitioner
Primary
29447
TN

Other

Enumeration date
06/03/2021
Last updated
03/06/2026
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