Basic Information
| Provider Information | |||||||||
| NPI: | 1043765324 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARRIS | ||||||||
| FirstName: | MIRANDA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 COMMERCE ST | ||||||||
| Address2: | SUITE 700 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372011826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154549850 | ||||||||
| FaxNumber: | 8884942588 | ||||||||
| Practice Location | |||||||||
| Address1: | 788 WASHINGTON RD | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152282021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123074609 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2016 | ||||||||
| LastUpdateDate: | 08/17/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | SP016431 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.