Tadevich, Miranda

Tadevich, Miranda is an individual health care provider with primary practice located at 445 W Eaton Ave , Tracy CA 95376-3420. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Tadevich, Miranda can be contacted via phone (209) 830-4075.

Contact Information

Primary practice address
445 W Eaton Ave Tracy CA 95376-3420
Phone: (209) 830-4075
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APN.0997765 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP95029206 California

Profile Details

NPI number 1669107512
LBN Legal business name Tadevich, Miranda
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2022
Last updated May 20th, 2024 - about last year

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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