Individual
MIRANDA KAAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA (ASCP)
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(513) 301-2542
Mailing address
145 INDIAN CREEK DR, COVINGTON, KY 41017-9139
(812) 972-1351
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
Primary
—
—
Other
Enumeration date
10/06/2023
Last updated
10/06/2023
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