Provider Demographics
NPI:1932482809
Name:BROWN, MIRANDA YVONNE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MIRANDA
Middle Name:YVONNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MIRANDA
Other - Middle Name:Y
Other - Last Name:VEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1410 E IRON AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3285
Mailing Address - Country:US
Mailing Address - Phone:316-706-1302
Mailing Address - Fax:785-826-1660
Practice Address - Street 1:1410 E IRON AVE STE 1
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3285
Practice Address - Country:US
Practice Address - Phone:316-706-1302
Practice Address - Fax:785-826-1660
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75441-121363L00000X
KS53-75441363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care