Individual
MIRANDA FITZPATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
807 CHEROKEE DR STE 5, MARSHALL, MO 65340-1690
(660) 202-4227
Mailing address
807 CHEROKEE DR STE 5, MARSHALL, MO 65340-1690
(660) 202-4227
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN245226
GA
363L00000X
Nurse Practitioner
Primary
2024006900
MO
363LF0000X
Family Nurse Practitioner
RN245226
GA
Other
Enumeration date
10/12/2017
Last updated
04/10/2024
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