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General NPI Number Information
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NPI Number | 1396526422
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Entity Type | Individual
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Provider Name | MIRANDA PHILLIPS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/13/2023
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 2303 VILLAGE DR
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-4954
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Country | US
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Telephone | 816-385-5997
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Fax |
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Provider Business Mailing Address
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Address Line | 2709 MEADOW RIDGE DR
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City | SAINT JOSEPH
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State | MO
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Zip | 64504-2200
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Country | US
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Telephone | 816-262-6149
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS65586
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2010033604
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License Number State | MO
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