Healthcare Provider Details

I. General information

NPI: 1932503737
Provider Name (Legal Business Name): ROSA MIRANDA RN MSN APRN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2014
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9092 WESTGATE PKWY W
AMARILLO TX
79124-2441
US

IV. Provider business mailing address

9092 WESTGATE PKWY W
AMARILLO TX
79124-2441
US

V. Phone/Fax

Practice location:
  • Phone: 806-358-1374
  • Fax: 806-356-0045
Mailing address:
  • Phone: 806-358-1374
  • Fax: 806-356-0045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP126704
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: