Wood, Miranda Dawn

Wood, Miranda Dawn is an individual health care provider with primary practice located at 1222 Trotwood Ave Suite 108, Columbia TN 38401-6436. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Wood, Miranda Dawn can be contacted via phone (931) 540-4140.

Contact Information

Primary practice address
1222 Trotwood Ave Suite 108 Columbia TN 38401-6436
Phone: (931) 540-4140
Fax: (931) 540-4142
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1592 Tennessee

Profile Details

NPI number 1184751745
LBN Legal business name Wood, Miranda Dawn
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2007
Last updated Apr 6th, 2015 - about 9 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 1184751745 NPPES
Tennessee MEDICAID 1505712
Tennessee Other 4191519
Tennessee MEDICAID 3710089

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