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NPI Code Detail

MEDICARE: DIANA MIRANDA APRN

MEDICARE: DIANA MIRANDA 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
1363LP0200XPediatric Nurse PractitionerAPRN-NP296293GA

General Provider Information

NPI Number : 1881540763
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA MIRANDA APRN
Provider Business Mailing Address
First Line : 1575 CHATTANOOGA AVE STE 1
Second Line :
City : DALTON
State : GA
Zip : 30720-2672
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1575 CHATTANOOGA AVE STE 1
Second Line :
City : DALTON
State : GA
Zip : 30720-2672
Country : US
Telephone Number : 706-876-2130
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/06/2026

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