| NPI | 1902464233 |
|---|---|
| Former Name | MIRANDA LYNN NORRIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 170741) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 170741-30) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 170741) | |
| Enumeration Date | 2019-06-02 |
| Last Update Date | 2019-06-27 |