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NPI Code Detail

MEDICARE: KARLA VANESSA MIRALLES DNP, APRN

MEDICARE: KARLA VANESSA MIRALLES DNP, APRN
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
1363LF0000XFamily Nurse PractitionerRN170709GA

Other Identifiers

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

General Provider Information

NPI Number : 1568450161
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARLA VANESSA MIRALLES DNP, APRN
Provider Business Mailing Address
First Line : 687 JOHNSON FERRY RD
Second Line :
City : MARIETTA
State : GA
Zip : 30068-6146
Country : US
Telephone Number : 770-977-9220
Fax Number :
Provider Business Practice Location Address
First Line : 687 JOHNSON FERRY RD
Second Line :
City : MARIETTA
State : GA
Zip : 30068-4628
Country : US
Telephone Number : 770-977-9220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2005
Last Update Date : 07/21/2022

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