Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1049200 | TX |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 1049200 | TX |
NPI | 1255005179 |
---|---|
Provider Name | Miranda Marquette |
First Address | The Colony, TX 75056-5433 |
Second Address | Dallas, TX 75203-1201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2021 |
Last Update Date | 04/08/2021 |