| NPI | 1215633862 |
|---|---|
| Former Name | MIRANDA JEAN LEILANI JANSING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3018687) |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2025-02-03 |