MEDICARE: KARINA LOPEZ MIRANDA MSN, APRN, WHNP-BC

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	363LW0102X	Women's Health Nurse Practitioner	1130986	TX

General Provider Information

NPI Number	:	1285418467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARINA LOPEZ MIRANDA MSN, APRN, WHNP-BC

Provider Business Mailing Address
First Line	:	1043 N BAGLEY ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75211-1145
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5939 HARRY HINES BLVD STE 300
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-6262
Country	:	US
Telephone Number	:	214-645-3838
Fax Number	:	214-645-6775

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

Provider Enumeration Date	:	08/21/2023
Last Update Date	:	08/21/2023

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