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Individual

MS. EKATERINA MIRONOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AG-ACNP

Contact information

Practice address
15 TSIENNETO RD, DERRY, NH 03038-1557
(603) 537-1300
Mailing address
6 BUTTRICK RD STE 102, LONDONDERRY, NH 03053-3417
(603) 537-1300

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
087881-23
NH
363LA2100X
Acute Care Nurse Practitioner
RN2329856
MA
363LA2100X
Acute Care Nurse Practitioner
TAP5715
AZ

Other

Enumeration date
07/21/2014
Last updated
10/26/2022
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