| NPI | 1760695639 |
|---|---|
| Professional Name | MIRANDA DANIELLE MATHIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: TN LPN0000056631) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-07-08 |