MIRANDA LYNN WARAXA NP NPI 1902464233

NPI Information

NPI: 1902464233
Provider Name: MIRANDA LYNN WARAXA, NP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
9200 W WISCONSIN AVE
MILWAUKEE, WI
ZIP 53226
Phone: (414) 955-6830
Get Directions

Miranda Lynn Waraxa, NP is an adult health nurse practitioner in Milwaukee, WI with 6 years of experience. Miranda Lynn Waraxa, NP NPI is 1902464233. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9200 W WISCONSIN AVE
MILWAUKEE, WI
ZIP 53226-522
Phone: (414) 955-6830
Fax: (414) 955-6214

The NPI 1902464233 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/2/2019 and was last updated on 6/27/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		170741-30	WISCONSIN	No
2	363LG0600X	Nurse Practitioner	Gerontology	170741	WISCONSIN	No
3	363LA2200X	Nurse Practitioner	Adult Health	170741	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1902464233	MEDICAID	WISCONSIN
2	170741-30	OTHER	WISCONSIN	WISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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