Provider Demographics
NPI:1962206730
Name:DAYE, MIRANDA ROSE (DO)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:ROSE
Last Name:DAYE
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:MIRANDA
Other - Middle Name:ROSE
Other - Last Name:ORTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:N6210 9TH DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53964-8922
Mailing Address - Country:US
Mailing Address - Phone:715-896-6188
Mailing Address - Fax:
Practice Address - Street 1:1350 S KINGS DR FL 3
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2134
Practice Address - Country:US
Practice Address - Phone:704-446-1242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program