Healthcare Provider Details

I. General information

NPI: 1104744507
Provider Name (Legal Business Name): MIRANDA KASHELLE ZUNIGA RN-BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12424 N 32ND ST STE 100
PHOENIX AZ
85032-7156
US

IV. Provider business mailing address

12636 N 113TH AVE
YOUNGTOWN AZ
85363-1148
US

V. Phone/Fax

Practice location:
  • Phone: 480-284-7567
  • Fax:
Mailing address:
  • Phone: 602-686-0222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number301785
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: