Provider Demographics
NPI:1467747147
Name:BROWER, MIRANDA
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:
Last Name:BROWER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 11TH ST. S.W.
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-5801
Mailing Address - Country:US
Mailing Address - Phone:712-580-4570
Mailing Address - Fax:712-580-4573
Practice Address - Street 1:337 11TH ST. S.W.
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-5801
Practice Address - Country:US
Practice Address - Phone:712-580-4570
Practice Address - Fax:712-580-4573
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA127894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily