Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | COA.11115-NP | OH |
NPI | 1023343506 |
---|---|
Provider Name | Miranda L Quintana |
First Address | New Albany, OH 43054-7102 |
Second Address | New Albany, OH 43054-7102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2009 |
Last Update Date | 30/04/2021 |