Provider Demographics
NPI:1154290161
Name:MIRANDA, KATRINA LASHAWN
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:LASHAWN
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2854 BROWNE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-2053
Mailing Address - Country:US
Mailing Address - Phone:402-503-5320
Mailing Address - Fax:
Practice Address - Street 1:11635 ARBOR ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5000
Practice Address - Country:US
Practice Address - Phone:402-503-5320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-30
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide