Mallicoat, Miranda

Mallicoat, Miranda is an sole proprietor health care provider with primary practice located at 3900 Kresge Way Ste 51 , Louisville KY 40207-4683. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Technologists, Technicians & Other Technical Service Providers / Surgical Assistant. Technologists, Technicians & Other Technical Service Providers / Surgical Assistant is her primary health care specialty. Mallicoat, Miranda can be contacted via phone (502) 259-5955.

Contact Information

Primary practice address
3900 Kresge Way Ste 51 Louisville KY 40207-4683
Phone: (502) 259-5955
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X TSA026 Kentucky
Technologists, Technicians & Other Technical Service Providers / Surgical Assistant 246ZC0007X TSA026 Kentucky

Profile Details

NPI number 1487309290
LBN Legal business name Mallicoat, Miranda
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 21st, 2022
Last updated Mar 9th, 2022 - about 2 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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