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NPI Code Detail

MEDICARE: MIRANDA LENN-MORAN CSFA

MEDICARE: MIRANDA LENN-MORAN CSFA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246ZC0007XSurgical AssistantSA.0002598CO

General Provider Information

NPI Number : 1124658844
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRANDA LENN-MORAN CSFA
Provider Business Mailing Address
First Line : 4317 HESSITE LOOP
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80938-9602
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3010 N CIRCLE DR STE 100
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-1174
Country : US
Telephone Number : 720-590-9629
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2020
Last Update Date : 01/22/2020

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Directions to “ MIRANDA LENN-MORAN CSFA” Practice Location

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