Individual provider · Type 1 NPI
Miranda Mae Pickens, FNP
Family Nurse Practitioner · Sullivan, MO
NPI number
1093488322
Active
Practice location
1326 S Service Rd W
Sullivan, MO 63080-2306
Mailing address
1788 Pottery Rd
Washington, MO 63090-4189
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 2021026494 (MO) |
Family Nurse Practitioner: Definition to come...
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About NPI 1093488322
Miranda Mae Pickens, FNP's National Provider Identifier is 1093488322, issued on Aug 2, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Sullivan, MO. The record was last updated on Aug 2, 2021.