Jordan, Miranda Lyalls

Jordan, Miranda Lyalls is an individual health care provider with primary practice located at 310 Hospital Ave , Jefferson NC 28640. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Jordan, Miranda Lyalls can be contacted via phone (336) 846-6322.

Contact Information

Primary practice address
310 Hospital Ave Jefferson NC 28640
Phone: (336) 846-6322
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 5011326 North Carolina

Profile Details

NPI number 1457824393
LBN Legal business name Jordan, Miranda Lyalls
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2019
Last updated Jan 3rd, 2019 - about 6 years 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 1457824393 NPPES
North Carolina MEDICAID 1619907334

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