| NPI | 1386451615 | 
|---|---|
| Former Name | MIRANDA ALEXIS CARSON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: VA 24192047) | 
| Enumeration Date | 2024-12-11 | 
| Last Update Date | 2024-12-11 |