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General NPI Number Information
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NPI Number | 1548990021
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Entity Type | Individual
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Provider Name | MIRANDA MINTER
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Gender | Female
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 7200 S ALTON WAY STE A270
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City | CENTENNIAL
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State | CO
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Zip | 80112-2249
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Country | US
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Telephone | 720-536-8427
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Fax |
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Provider Business Mailing Address
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Address Line | 5263 S OLATHE CIR
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City | CENTENNIAL
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State | CO
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Zip | 80015-4117
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0997648
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License Number State | CO
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