Hickle, Miranda

Hickle, Miranda is an individual health care provider with primary practice located at 1059 E Highway 11 E , Jefferson City TN 37760-4910. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Hickle, Miranda can be contacted via phone (865) 375-6005.

Contact Information

Primary practice address
1059 E Highway 11 E Jefferson City TN 37760-4910
Phone: (865) 375-6005
Fax: (865) 471-0244
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 16752 Tennessee

Profile Details

NPI number 1528317054
LBN Legal business name Hickle, Miranda
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2012
Last updated Feb 9th, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528317054 NPPES
Tennessee MEDICAID 1530430

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