Provider Demographics
NPI:1508662255
Name:MIRANDA, LINDA TERESA
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:TERESA
Last Name:MIRANDA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E NORTH ST
Mailing Address - Street 2:
Mailing Address - City:FOSTORIA
Mailing Address - State:OH
Mailing Address - Zip Code:44830-2829
Mailing Address - Country:US
Mailing Address - Phone:614-783-0130
Mailing Address - Fax:
Practice Address - Street 1:1301 PARKSIDE PL
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-5568
Practice Address - Country:US
Practice Address - Phone:614-783-0130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide