MEDICARE: HILLARY MIRANDA NP

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	L1-0047360	DE
2	363LF0000X	Family Nurse Practitioner	71017853A	IN
3	363L00000X	Nurse Practitioner	LG-0001232	DE

General Provider Information

NPI Number	:	1720441405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HILLARY MIRANDA NP

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	996 S STATE ROAD 135 STE P
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46143-7366
Country	:	US
Telephone Number	:	317-893-3888
Fax Number	:

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

Provider Enumeration Date	:	03/31/2016
Last Update Date	:	06/03/2026

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Directions to “ HILLARY MIRANDA NP” Practice Location

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