Miranda, Lisa M

Miranda, Lisa M is an individual health care provider with primary practice located at 568 N Sunrise Ave Ste 250 , Roseville CA 95661. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Miranda, Lisa M can be contacted via phone (916) 865-1140.

Contact Information

Primary practice address
568 N Sunrise Ave Ste 250 Roseville CA 95661
Phone: (916) 865-1140
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA1051 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA15570 California

Profile Details

NPI number 1144314766
LBN Legal business name Miranda, Lisa M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Mar 6th, 2019 - about 5 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 1144314766 NPPES
Tennessee Other 970027904 RAILROAD MEDICARE
Tennessee Other 2000307 RAILROAD MEDICARE
Tennessee Other TN0102 RAILROAD MEDICARE
Tennessee MEDICAID 3661837 RAILROAD MEDICARE
Tennessee Other 0140208 RAILROAD MEDICARE
Tennessee Other 621038898 RAILROAD MEDICARE
Tennessee Other FP62706 RAILROAD MEDICARE

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