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General NPI Number Information
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NPI Number | 1437282522
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Entity Type | Individual
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Provider Name | ROSA MARIA JAVIER MIRANDA N.P.,
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11234 ANDERSON ST
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City | LOMA LINDA
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State | CA
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Zip | 92354-2804
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Country | US
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Telephone | 909-558-8570
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Fax |
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Provider Business Mailing Address
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Address Line | 15740 OLIVER ST
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City | MORENO VALLEY
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State | CA
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Zip | 92555-4908
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Country | US
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Telephone | 951-242-2106
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 374694
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License Number State | CA
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