Individual provider · Type 1 NPI
Miranda Fordham Blais, WHNP-BC
Women's Health Nurse Practitioner · Brookhaven, GA
NPI number
1639607625
Active
Practice location
3369 Buford Hwy NE Ste 810A
Brookhaven, GA 30329-1742
Mailing address
491 Park Valley Dr NW
Atlanta, GA 30318-6251
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | RN216488 (GA) |
| Women's Health Nurse Practitioner Primary | 363LW0102X | RN216488 (GA) |
Women's Health Nurse Practitioner: Definition to come...
Other women's health nurse practitioner providers in Brookhaven
About NPI 1639607625
Miranda Fordham Blais, WHNP-BC's National Provider Identifier is 1639607625, issued on Jun 2, 2017. The primary taxonomy on file is Women's Health Nurse Practitioner (363LW0102X), and the practice location is in Brookhaven, GA. The record was last updated on Feb 18, 2022.