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:
Health care specialties
| Specialty | Code | License # | 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 4 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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