Provider Demographics
NPI:1932503737
Name:MIRANDA, ROSA (RN MSN APRN FNP-C)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:RN MSN APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 S COULTER ST STE 305
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1768
Mailing Address - Country:US
Mailing Address - Phone:806-358-1374
Mailing Address - Fax:806-356-0045
Practice Address - Street 1:1215 S COULTER ST STE 305
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1768
Practice Address - Country:US
Practice Address - Phone:806-358-8331
Practice Address - Fax:806-356-0045
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-22
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126704363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily