Individual
MIRANDA LARAE VANCIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
307 W HWY 54 STE 300, ANDOVER, KS 67002-7849
(316) 218-0008
(162) 180-0033
Mailing address
1410 N WOODLAWN BLVD, DERBY, KS 67037-2953
(316) 788-3741
(316) 788-5198
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-77657
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
KS
Enumeration date
05/24/2017
Last updated
11/11/2024
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