Individual
MIRANDA KORTENHOEVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2930 11TH AVE, EVANS, CO 80620-1011
(720) 388-4907
Mailing address
2930 11TH AVE, EVANS, CO 80620-1011
(720) 388-4907
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0009432
CO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/03/2025
Last updated
01/20/2026
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