Provider Demographics
NPI:1821614587
Name:MIRANDA, BRITTANY A (FNP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:A
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28413 N 207TH AVE
Mailing Address - Street 2:
Mailing Address - City:WITTMANN
Mailing Address - State:AZ
Mailing Address - Zip Code:85361-9736
Mailing Address - Country:US
Mailing Address - Phone:602-510-6780
Mailing Address - Fax:
Practice Address - Street 1:34525 N SCOTTSDALE RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85266-1201
Practice Address - Country:US
Practice Address - Phone:480-882-7550
Practice Address - Fax:480-575-3076
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ242780363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily