Individual provider · Type 1 NPI

Miranda R. Dethier, PA-C

Physician Assistant · Menomonee Falls, WI

NPI number 1760770960 Active

Practice location

W165N5595 Creekwood Xing
Menomonee Falls, WI 53051-0685

Call (262) 252-1050 Map

Fax (262) 525-4781

Mailing address

470 E Red Pine Cir
Dousman, WI 53118-8828

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X2758-23 (WI)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1760770960

Miranda R. Dethier, PA-C's National Provider Identifier is 1760770960, issued on Jul 21, 2011. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Menomonee Falls, WI. The record was last updated on Jun 23, 2026.