Individual
AUDREY MIRANDA MAYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
945 FOREST ST, DOVER, DE 19904-3401
(302) 672-1658
Mailing address
945 FOREST ST, DOVER, DE 19904-3401
(302) 672-1658
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
L1-0034396
DE
Other
Enumeration date
01/05/2009
Last updated
01/05/2009
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