Individual
MS. MIRANDA CHRISTMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
801 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3204
(262) 497-9446
Mailing address
2604 21ST ST, KENOSHA, WI 53140-1775
(262) 497-9446
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
3943
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3843
NATIONAL SURGICAL ASSISTANT ASSOCIATION
WI
Enumeration date
07/24/2012
Last updated
07/24/2012
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