MEDICARE: MIRANDA STONE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	310503	NC

General Provider Information

NPI Number	:	1841155371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRANDA STONE

Provider Business Mailing Address
First Line	:	6132 RIVERSIDE DR
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-9540
Country	:	US
Telephone Number	:	252-209-4172
Fax Number	:

Provider Business Practice Location Address
First Line	:	6132 RIVERSIDE DR
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-9540
Country	:	US
Telephone Number	:	252-209-4172
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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Directions to “ MIRANDA STONE ” Practice Location

Language	Start Address	Practice Location

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