MEDICARE: MIRANDA DENISE BROWN-MEADERS LPA

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	103T00000X	Psychologist	4017	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336381235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRANDA DENISE BROWN-MEADERS LPA

Provider Business Mailing Address
First Line	:	2328 OZARK CT
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-9809
Country	:	US
Telephone Number	:	803-325-5491
Fax Number	:

Provider Business Practice Location Address
First Line	:	13735 STEELE CREEK RD STE 200
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-6841
Country	:	US
Telephone Number	:	803-325-5491
Fax Number	:	800-487-7401

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

Provider Enumeration Date	:	03/24/2009
Last Update Date	:	07/21/2022

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