MIRANDA MICHELLE ROACH (NPI# 1184240285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184240285 |
| Entity Type | Individual |
| Full Name | MIRANDA MICHELLE ROACH |
| Credential | FNP-C |
| Practice Address |
11907 Candlewood Pl Montgomery TX 77356-5427 |
| Practice Telephone | 7204803790 |
| Mailing Telephone | 7204803790 |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2020-06-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP145597 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11907 CANDLEWOOD PL |
| City | MONTGOMERY |
| State | TX |
| Zip Code | 77356-5427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952919490 | Age Well Concierge Medicine | Family Medicine | 18441 Tx-105, Suite B, Montgomery, TX 77356 | 2020-07-21 |
| 1912549908 | Kindra Siewood | Speech-Language Pathologist | 15320 Tx-105 W, Suite 116, Montgomery, TX 77356 | 2019-10-11 |
| 1710545595 | Vaughn Motley Bryant IIi | Counselor | 14740 Liberty Street, Montgomery, TX 77356 | 2019-06-05 |
| 1871157420 | Belinda Kay Warren Delapena | Counselor | 3507 Whittier, Montgomery, TX 77356 | 2019-04-30 |
| 1841760071 | Cvs Pharmacy Inc | Pharmacy | 20125 Eva Street, Montgomery, TX 77356 | 2018-11-30 |
| 1750863429 | Kristina Lynn Knighten | Specialist/Technologist | 3602 Woodland Lane, Montgomery, TX 77356 | 2018-08-30 |
| 1770072415 | Crosby Pharmacy & Wellness, LLC | Pharmacy | 18446 Tx - 105 Ste D, Montgomery, TX 77356 | 2018-05-08 |
| 1760999726 | Everbright Dental Pllc | Dentist | 20212 Eva St., #160, Montgomery, TX 77356 | 2017-12-29 |
| 1821535261 | Ramon Campbell | Nurse Practitioner | 108 Harbour Town Drive, Montgomery, TX 77356 | 2017-01-24 |
| 1447628995 | Erica Everett | Nurse Practitioner | 110 April Wind Ct, Montgomery, TX 77356 | 2015-09-14 |
| Find all providers in zip 77356 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508416611 | Casey Thornton | Nurse Practitioner | 370 Saint Lukes Dr, Montgomery, AL 36117-7111 | 2019-09-19 |
| 1558917047 | Brittany Ann Smith | Nurse Practitioner | 1722 Pine St Ste 904, Montgomery, AL 36106-1104 | 2019-08-12 |
| 1952956567 | Cassandra Aileen Kelley | Nurse Practitioner | 1722 Pine St Ste 401, Montgomery, AL 36106-1103 | 2019-08-09 |
| 1982264867 | Bethany Fain Phelps | Nurse Practitioner | 1722 Pine St Ste 402, Montgomery, AL 36106-1159 | 2019-06-13 |
| 1447813027 | Haley Harvey Clifton | Nurse Practitioner | 1758 Park Pl Ste 401, Montgomery, AL 36106-1135 | 2019-04-18 |
| 1861958241 | Tameka Lene' Myles | Nurse Practitioner | 2905 East South Boulevard, Montgomery, AL 36116 | 2019-02-11 |
| 1780162024 | Grace Santana | Nurse Practitioner | 3270 Gatsby Ln, Montgomery, AL 36106-2668 | 2018-07-30 |
| 1013494673 | Angela K Rayborn | Nurse Practitioner | 1725 W 4th St # Na, Montgomery, AL 36106-1509 | 2018-07-25 |
| 1942795430 | Richard Yullambo Yenkong | Nurse Practitioner | 2270 Jericho Rd Apt A5, Montgomery, IL 60538-5621 | 2018-06-27 |
| 1710470554 | Andrea Kaye Steinbrink | Nurse Practitioner | 1758 Park Pl Ste 406, Montgomery, AL 36106-1135 | 2018-06-06 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 77356 |
Please comment or provide details below to improve the information on MIRANDA MICHELLE ROACH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.