Provider Demographics
NPI:1922889849
Name:KAAKE, MIRANDA (MS, PA (ASCP))
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:
Last Name:KAAKE
Suffix:
Gender:F
Credentials:MS, PA (ASCP)
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Other - Credentials:
Mailing Address - Street 1:145 INDIAN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41017-9139
Mailing Address - Country:US
Mailing Address - Phone:812-972-1351
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-3403
Practice Address - Country:US
Practice Address - Phone:513-301-2542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory