Healthcare Provider Details

I. General information

NPI: 1487585832
Provider Name (Legal Business Name): MIRANDA CRANSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3005 47TH ST STE F1
BOULDER CO
80301-5550
US

IV. Provider business mailing address

580 DUVAL DR
ALPHARETTA GA
30009-4912
US

V. Phone/Fax

Practice location:
  • Phone: 303-955-6809
  • Fax:
Mailing address:
  • Phone: 770-624-0583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-NP295670
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: