Individual
EMILY OLIVIA MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,CNP
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
Mailing address
400 E 3RD ST, D, MN 55805-1951
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
R49566
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/17/2020
Last updated
07/29/2020
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