Individual
MIRANDA KRISHNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
225 PHYSICIANS PARK STE 400, POPLAR BLUFF, MO 63901-3923
(573) 727-5500
(573) 727-5599
Mailing address
PO BOX 801143, KANSAS CITY, MO 64180-1143
(573) 331-5583
(573) 331-5079
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2012022527
MO
363LF0000X
Family Nurse Practitioner
Primary
2016041522
MO
Other
Enumeration date
05/31/2017
Last updated
03/04/2021
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