Individual
MIRANDA PREWITT BROOKSHIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
29 CANARY LN, WINCHESTER, KY 40391-1645
(859) 745-4469
(859) 745-6918
Mailing address
1520 BOONESBORO RD, WINCHESTER, KY 40391-8816
(859) 744-0067
(859) 744-0042
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA495
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95005765
—
KY
Enumeration date
01/23/2007
Last updated
03/26/2016
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