Individual
STEVEN MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1471 MOUNTAIN VIEW LN APT 4, IDAHO FALLS, ID 83402-1861
(707) 391-0538
Mailing address
1471 MOUNTAIN VIEW LN APT 4, IDAHO FALLS, ID 83402-1861
(707) 391-0538
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-45963
ID
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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