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1679053706
MARISSA MIRAKIAN
KANSAS CITY, MO
NPI
1679053706
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MO 2018032917)
Enumeration Date
2018-08-17
Last Update Date
2018-09-24
Business Address
MARISSA MIRAKIAN
2401 GILLHAM RD
KANSAS CITY, MO 64108
Phone number: 816-302-8547
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Mailing Address
MARISSA MIRAKIAN
2401 GILLHAM RD PROVIDER ENROLLMENT
KANSAS CITY, MO 64108-4619
Phone number: 816-701-5200
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