Individual
MR. KEVIN MIRANDOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-CP
Contact information
Practice address
180 CORLISS ST STE E, PROVIDENCE, RI 02904-2602
(401) 793-2928
Mailing address
454 INDIAN CORNER RD, SAUNDERSTOWN, RI 02874-2114
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN02408
RI
363LF0000X
Family Nurse Practitioner
F06200729
RI
Other
Enumeration date
06/20/2020
Last updated
09/23/2020
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