Provider Demographics
NPI:1679866446
Name:ADKINS, MIRANDA R
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:R
Last Name:ADKINS
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 1:314 FOWLER ST
Mailing Address - Street 2:
Mailing Address - City:MAPLE HILL
Mailing Address - State:KS
Mailing Address - Zip Code:66507-9050
Mailing Address - Country:US
Mailing Address - Phone:785-969-8027
Mailing Address - Fax:
Practice Address - Street 1:325 SW FRAZIER AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1963
Practice Address - Country:US
Practice Address - Phone:785-232-5005
Practice Address - Fax:785-232-7981
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker