Provider Demographics
NPI:1801433230
Name:MIRANDA-SHEFFIELD, MERCEDES ELIETH (CRNP)
Entity type:Individual
Prefix:
First Name:MERCEDES
Middle Name:ELIETH
Last Name:MIRANDA-SHEFFIELD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 UNIVERSITY BLVD W STE 420
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-1972
Mailing Address - Country:US
Mailing Address - Phone:240-669-6330
Mailing Address - Fax:
Practice Address - Street 1:2730 UNIVERSITY BLVD W STE 420
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-1972
Practice Address - Country:US
Practice Address - Phone:240-669-6330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR228947363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily