MEDICARE: MIRANDA KATE WENGER RN

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
1	163W00000X	Registered Nurse	RN783915	PA

General Provider Information

NPI Number	:	1235073404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRANDA KATE WENGER RN

Provider Business Mailing Address
First Line	:	1318 WOODLAND CIR
Second Line	:
City	:	DENVER
State	:	PA
Zip	:	17517-9761
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2465 NEW HOLLAND PIKE
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-5935
Country	:	US
Telephone Number	:	717-617-0092
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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