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:
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184751745 | NPPES |
| Tennessee | MEDICAID | 1505712 | |
| Tennessee | Other | 4191519 | |
| Tennessee | MEDICAID | 3710089 |
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