Individual
KELLY MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADN
Contact information
Practice address
10764 HERITAGE RD, LINCOLN, DE 19960-4019
(956) 451-2929
Mailing address
10764 HERITAGE RD, LINCOLN, DE 19960-4019
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
L1-0029696
DE
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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