Provider Demographics
NPI:1316274087
Name:FLOWERS, MIRANDA KENT (NP)
Entity type:Individual
Prefix:MRS
First Name:MIRANDA
Middle Name:KENT
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:MIRANDA
Other - Middle Name:SHANE
Other - Last Name:KENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2301 ERWIN ROAD
Mailing Address - Street 2:DUMC BOX 3458
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0000
Mailing Address - Country:US
Mailing Address - Phone:919-681-2425
Mailing Address - Fax:919-681-7163
Practice Address - Street 1:2301 ERWIN ROAD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0000
Practice Address - Country:US
Practice Address - Phone:919-681-2425
Practice Address - Fax:919-681-7163
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207091363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health