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General NPI Number Information
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NPI Number | 1205429941
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Entity Type | Individual
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Provider Name | MIRIANDA NDAPTSO
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Gender | Female
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Dates
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Enumeration Date | 02/13/2021
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 3008 EDGEFIELD DR SW
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City | MARIETTA
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State | GA
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Zip | 30008-7665
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Country | US
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Telephone | 678-497-5145
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Fax |
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Provider Business Mailing Address
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Address Line | 3008 EDGEFIELD DR SW
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City | MARIETTA
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State | GA
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Zip | 30008-7665
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Country | US
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Telephone | 678-497-5145
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | GAA-NPO00690
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number | GAA-NPO00690
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | GAA-NPO00690
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License Number State | GA
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