Provider Demographics
NPI:1760811483
Name:MIRAN, FARRAH MAY CATOLICO (RN)
Entity Type:Individual
Prefix:MRS
First Name:FARRAH MAY
Middle Name:CATOLICO
Last Name:MIRAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13517 5TH AVENUE CT S
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-4711
Mailing Address - Country:US
Mailing Address - Phone:253-212-3129
Mailing Address - Fax:
Practice Address - Street 1:13517 5TH AVENUE CT S
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-4711
Practice Address - Country:US
Practice Address - Phone:253-212-3129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00149470163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse